Evaluation of the nutritional status of children with TYPE 1 diabetes using insulin pen and insulin PUMP

Type 1 diabetes is an insulin-dependent type of diabetes. Insulin pen or insulin pump is used for insulin infusion. Differences in insulin infusion method may also be effective on diabetes management. This study was conducted to evaluate the nutritional status of children with Type 1 diabetes who use insulin pen and insulin pump. The study was conducted on 40 children with Type 1 diabetes between the ages of 2 and 12 who applied to a private endocrine clinic between January 2021 and March 2021. The personal characteristics of the individuals, their information about diabetes and their eating habits were collected with a questionnaire. Daily energy, macro and micronutrient intake was calculated by taking a 3-day nutrient consumption record. Anthropometric measurements (body weight (kg) and height (cm)) of the individuals were taken, BMI and ponderal index values were calculated, and biochemical findings (HbA1c, hemoglobin, hematocrit, iron, ferritin, Vitamin B12, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, creatinine) were analyzed. Of the children with type 1 diabetes, 22 (55,0%) were girls and 18 (45,0%) were boys. The mean age of the children participating in the study is 8.1±2.94 years. The mean of the last 3 HbA1c of the children is 7.2±0.64. It was observed that the median score of Triglyceride, mg/dL of children using insulin pen was higher than those using insulin pump (p<0.05). Poor HbA1c: No child with >9%. There was no statistically significant relationship between insulin use and HbA1c levels (p>0.05). There was no statistically significant relationship between BMI groups according to age of children using insulin pen and insulin pump (p=0.373). A statistically significant correlation was found between the type of insulin use and the ponderal index in girls (p<0.05). While the energy, carbohydrate and fiber intakes of children are below the Turkey Dietary Guidelines 2015 recommendations, their protein and fat intakes were found close to the recommendations. When the energy and macronutrient intakes of children using insulin pen and insulin pump were examined, no significant difference was found between them (p>0.05). Daily intake of vitamin E, thiamine, niacin and folate in children using both an insulin pen and an insulin pump was found below the recommendations according to TUBER, the intake of vitamin A, riboflavin, vitamin B6 and vitamin B12 was above the recommendations, and the intake of vitamin C was close to the recommendations. Considering all of the children, daily sodium and phosphorus intake was above the TUBER recommendations, and potassium, calcium, magnesium and iron intakes were below the recommendations. While daily zinc intake is close to TUBER recommendations for insulin pump users, it is below the recommendations for insulin pen users. Daily intake of thiamine, magnesium and iron was lower in insulin pen users than in insulin pump users (p<0.05). In this study, no significant difference was found between the nutritional status of children using an insulin pump and an insulin pen. It is thought that meaningful results will be obtained with a longer-term study with a larger number of patients.