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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Variation in nutrition education practices in SWEET pediatric diabetes centers-an international comparison

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DOI

  1. International comparison of glycaemic control in people with type 1 diabetes: an update and extension

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  2. School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study

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  3. Center differences in diabetes treatment outcomes among children with type 1 diabetes: A nationwide study of 3866 Danish children

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  4. Association of type 1 diabetes and educational achievement in 16-20-year-olds: A Danish nationwide register study

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  5. El ABC de los registros de diabetes

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Guy Todd Alonso
  • Katharina Fink
  • Claudio Maffeis
  • Svensson Jannet
  • Krepel-Volsky Sari
  • Davis Elizabeth
  • Jarosz-Chobot Przemysława
  • Patel Yash
  • Smart Carmel
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BACKGROUND: Nutrition education is central to pediatric type 1 diabetes management. Dietary management guidelines for type 1 diabetes are evidence based, but implementation may be challenging and inconsistent. We describe variation in the practice of nutrition education across pediatric diabetes centers globally and explore associations with A1c and BMI.

METHODS: In 2018, 77 pediatric diabetes clinics in the SWEET network received a survey about nutrition education. Using data submitted to the registry, regression analysis corrected for age, diabetes duration, BMI, and sex was used to compare survey parameters with A1c and BMI.

RESULTS: Fifty-three centers who collectively cared for 22,085 patients aged 0 to 18 with type 1 diabetes responded. Median A1c was 7.68% [IQR 7.37-8.03], age 13.13 y [12.60-13.54], insulin pump use 39.1%, and continuous glucose monitor use 37.3%. 34% reported screening for disordered eating, but only 15.1% used validated screening tools. Recommending insulin boluses for snacks in patients taking insulin via injection varied, with 23% of the clinics giving this recommendation to half or fewer patients. In regression analysis, instructing patients to take insulin for snacks was the only survey parameter associated with the percent of clinic percent of patients attaining A1c <7.5% (<58 mmol/mol, P = 0.018) and < 7.0% (<53 mmol/mol, P = 0.026).

CONCLUSIONS: There is considerable variation in nutrition education for pediatric patients with type 1 diabetes across this international registry. Consistently recommending independent of treatment modality (insulin pump or injections) that patients take insulin for snacks and more uniformity in screening for disordered eating are improvement opportunities.

Original languageEnglish
JournalPediatric Diabetes
Volume22
Issue number2
Pages (from-to)215-220
Number of pages6
ISSN1399-543X
DOIs
Publication statusPublished - Mar 2021

ID: 62430303