Unhealthy eating habits are associated with obesity, metabolic syndrome, and increased insulin resistance in young patients with type 1 diabetes mellitus (T1DM), and may impact the possible benefit from dietary interventions on glycaemic control. This study determines how nutritional patterns influence the quality of dietary intervention with a 30% or 50% carbohydrate diet in terms of glycaemic control measured with continuous glucose monitoring (CGM). Eating habits were obtained with a frequency-of-consumption questionnaire (FFQ-6) before the diet assessment. Altogether, we collected CGM and FFQ-6 data from 30 children (16 boys and 14 girls aged 10–17 years) with T1DM subjected to two consecutive 3-day nutritional plans. From these, 23 patients met the CGM data quality criteria for further analysis. Furthermore, high accuracy achieved in training (95.65%) and V-fold cross-validation (81.67%) suggest a significant impact of food habits in response to introduced nutritional changes. Patients who consumed more vegetables or grains (>4 times per day), more wheat products (>once per day), fewer fats (<1.5 times per day), and ranked fruit juice as the most common selection in the drinks category achieved glycaemic control more often after the introduction of a 30% carbohydrate diet, as opposed to those with different dietary patterns, whose glycaemic control was negatively impacted after switching to this diet. Additionally, the 50% carbohydrate diet was safe for all patients in the context of glycaemic control.
The purpose of this study was to investigate the influence of maximal oxygen uptake (VO2 max) on the glycemic changes during low and high intensity exercises in young type 1 diabetic patients. Twenty boys (age: 14.3 ± 1.6 years; height: 171.0 ± 11.3 cm; weight; 59.5 ± 12.8 kg) were divided into low-fit group (LFG, n = 10) and high-fit group (HFG, n = 10). According to the experimental design, participants performed three physical efforts (VO2 max test, mixed aerobic–anaerobic effort and aerobic effort) on the cycloergometer, during which real-time glycemia was measured. Mixed aerobic–anaerobic exercise demanded significantly smaller carbohydrate supplementation (0.2 ± 0.2 g/kg during exercise) than the aerobic test session (0.4 ± 0.3 g/kg during exercise). Moreover, patients with higher VO2 max had lower tendency for glycemic changes during the aerobic effort. The results of the current study suggest that young type 1 diabetic patients should perform different intensity activities using continuous glycemic monitoring system to avoid acute and chronic complications of the disease.
Therapy for type 1 diabetes (T1DM) focuses on maintaining optimal blood glucose levels, achieved with intensive insulin treatment, proper nutrition, and physical activity. The aim of this study was to investigate postprandial glycemic changes under low (30%) and standard (50%) carbohydrate diets in adolescents with T1DM. A single-center cross-over nutritional study was conducted, during which 26 adolescent patients provided 220 continuous glucose-monitored (CGM) meals data from the two consecutive 3-day nutritional plans. Overall, the 50% carbohydrate diet was associated with higher postprandial glucose variability in the small meals (afternoon snacks, second breakfast) and greater postprandial peaks for other meals (breakfast, dinner, supper). Nevertheless, after the adjustment of a patient’s individual clinical variables (age, Tanner classification, glucose disposal rate), we observed that mean postprandial glucose was higher for afternoon snacks and lower for suppers in the 30% carbohydrate diet. Although a 30% carbohydrate diet seems to offer better postprandial glycemia, it requires additional attention from the physician and patient when it comes to modifying daily carbohydrate intake. Increased fat/protein content and size of the main meal lead to a prolonged postprandial glycemic response, which may affect the insulin treatment and result in suboptimal glycemic control.
1 January 2021 in Pediatric Endocrinology Diabetes and Metabolism
Currently, 5–10% of diabetes patients are teenagers. During this period the influence of peers and observation of their eating habits plays a significant role. Unfortunately, they differ from the principles of proper nutrition, which according to the PTD Diabetes Poland should be introduced as an element of proper metabolic compensation. To assess the condition and dietary habits of male adolescents with type 1 diabetes and to compare their eating habits to generally accepted standards. The study participants include 20 boys, aged 14.6 ±1.58 years, with type 1 diabetes mellitus treated with a personal insulin pump who were diagnosed using ISPAD criteria. In the study anthropometric and questionnaire methods were used, as well as body composition analysis. In most of the examined subjects, the assessment of nutritional status indicates a proper proportion of adipose tissue (14.72 ±6.25%, 8.71 ±4.10 kg per kg) and muscle mass in the body (28.2 ±6.93 kg). Unfortunately in a significant group of adolescents, the diet is not properly balanced. Particularly the common problem is the excess of total carbohydrates, including simple sugars. To sum up, despite systematic education of proper nutrition on glycemic control and prevention of acute and chronic complications, the eating habits of male adolescents differ from those of proper nutrition. Additionally, it should be noted that despite the proper results of the body composition analysis, there is a problem with an erroneously balanced diet.
The main purpose of this study was to investigate the differences in glycaemic reaction in response to various physical activities in 20 young boys (14.4 ± 1.6 years) with type 1 diabetes mellitus (T1DM) and with either vitamin D deficiency or with suboptimal levels of vitamin D. Participants were divided into two groups (deficiency group—DG, n = 10; suboptimal group—SG, n = 10) according to their vitamin D levels. All patients performed aerobic and mixed (aerobic-anaerobic) physical efforts. During the exercise, the respiratory responses and glucose levels were monitored. Biochemical blood analyses were performed before each physical effort. The oxygen consumption was not significantly lower in SG during both aerobic and mixed effort (4.0% and 5.6%, respectively). The glycated haemoglobin (HbA1c) level was higher by 6.1% and the total daily dose of insulin (DDI) was higher by 18.4% in the DG. The differences were not statistically significant. Patients with lower vitamin D levels demonstrated an insignificantly higher glycaemic variability during days with both aerobic and mixed exercises. An appropriate vitamin D concentration in T1DM patients’ blood may constitute a prophylactic factor for hyperglycaemia during anaerobic training and hypoglycaemia during aerobic training.
1 January 2024 in Pediatric Endocrinology Diabetes and Metabolism
Nowadays, continuous glycaemic monitoring systems are used primarily for diabetic patients. The most popular continuous glycaemic monitoring (CGMs) measure the glucose concentration in the interstitial fluid every 1 or 5 minutes, providing the patient with 288 or 1,440 measurements in a day. CGM...