Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes

The aim of this study was to evaluate the association between macronutrient intake and time in range (TIR) of 70–180 mg/dL in children and adolescents with type 1 diabetes (T1D). A multi-center study recruited patients with T1D using continuous glucose monitoring (CGM) between January 2019 and Janua...

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Autores principales:	Valentino Cherubini, Monica Marino, Marco Marigliano, Claudio Maffeis, Angela Zanfardino, Ivana Rabbone, Sara Giorda, Riccardo Schiaffini, Antonella Lorubbio, Serena Rollato, Antonio Iannilli, Dario Iafusco, Andrea E. Scaramuzza, Renee Bowers, Rosaria Gesuita
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	time in range macronutrients children and adolescents type 1 diabetes multi-center observational study continuous glucose monitoring Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/74f36fed965840c48887f0a130d57a70
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spelling	oai:doaj.org-article:74f36fed965840c48887f0a130d57a702021-11-25T18:34:48ZRethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes10.3390/nu131138692072-6643https://doaj.org/article/74f36fed965840c48887f0a130d57a702021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3869https://doaj.org/toc/2072-6643The aim of this study was to evaluate the association between macronutrient intake and time in range (TIR) of 70–180 mg/dL in children and adolescents with type 1 diabetes (T1D). A multi-center study recruited patients with T1D using continuous glucose monitoring (CGM) between January 2019 and January 2020 from centers across Italy. Diet intake was recorded using three-day weighed food diaries. Nutrients were evaluated as percentages of total intake. TIR was considered at target if the percentage of readings was higher than 70%. Clinical and nutritional factors associated with TIR at target were analyzed using multiple correspondence analysis and multiple logistic regression. Data from 197 participants (53% male, median age 11.6 years, median HbA1c 55.2 mmol/mol, median TIR 60%) were analyzed. Macronutrient intake was 45.9% carbohydrates, 16.9% protein, 37.3% fat, and 13.1 g/day fiber (median values). TIR > 70% was observed in 28% of participants; their diet contained more protein (17.6%, <i>p</i> = 0.015) and fiber (14.4 g/day, <i>p</i> = 0.031) than those not at target. The probability of having a TIR > 70% was significantly higher with 40–44% consumption of carbohydrates compared with 45–50% consumption of carbohydrates and with the use of a carbohydrate counting system. Based on these results, a five percent reduction in the percentage of carbohydrate intake can help children and adolescents with T1D achieve the goal of a TIR > 70%. Both a lower and higher percentage of carbohydrate intake appears to reduce the probability of reaching the target TIR > 70%. These results require validation in other populations before being used in clinical practice.Valentino CherubiniMonica MarinoMarco MariglianoClaudio MaffeisAngela ZanfardinoIvana RabboneSara GiordaRiccardo SchiaffiniAntonella LorubbioSerena RollatoAntonio IannilliDario IafuscoAndrea E. ScaramuzzaRenee BowersRosaria GesuitaMDPI AGarticletime in rangemacronutrientschildren and adolescentstype 1 diabetesmulti-center observational studycontinuous glucose monitoringNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3869, p 3869 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	time in range macronutrients children and adolescents type 1 diabetes multi-center observational study continuous glucose monitoring Nutrition. Foods and food supply TX341-641
spellingShingle	time in range macronutrients children and adolescents type 1 diabetes multi-center observational study continuous glucose monitoring Nutrition. Foods and food supply TX341-641 Valentino Cherubini Monica Marino Marco Marigliano Claudio Maffeis Angela Zanfardino Ivana Rabbone Sara Giorda Riccardo Schiaffini Antonella Lorubbio Serena Rollato Antonio Iannilli Dario Iafusco Andrea E. Scaramuzza Renee Bowers Rosaria Gesuita Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes
description	The aim of this study was to evaluate the association between macronutrient intake and time in range (TIR) of 70–180 mg/dL in children and adolescents with type 1 diabetes (T1D). A multi-center study recruited patients with T1D using continuous glucose monitoring (CGM) between January 2019 and January 2020 from centers across Italy. Diet intake was recorded using three-day weighed food diaries. Nutrients were evaluated as percentages of total intake. TIR was considered at target if the percentage of readings was higher than 70%. Clinical and nutritional factors associated with TIR at target were analyzed using multiple correspondence analysis and multiple logistic regression. Data from 197 participants (53% male, median age 11.6 years, median HbA1c 55.2 mmol/mol, median TIR 60%) were analyzed. Macronutrient intake was 45.9% carbohydrates, 16.9% protein, 37.3% fat, and 13.1 g/day fiber (median values). TIR > 70% was observed in 28% of participants; their diet contained more protein (17.6%, <i>p</i> = 0.015) and fiber (14.4 g/day, <i>p</i> = 0.031) than those not at target. The probability of having a TIR > 70% was significantly higher with 40–44% consumption of carbohydrates compared with 45–50% consumption of carbohydrates and with the use of a carbohydrate counting system. Based on these results, a five percent reduction in the percentage of carbohydrate intake can help children and adolescents with T1D achieve the goal of a TIR > 70%. Both a lower and higher percentage of carbohydrate intake appears to reduce the probability of reaching the target TIR > 70%. These results require validation in other populations before being used in clinical practice.
format	article
author	Valentino Cherubini Monica Marino Marco Marigliano Claudio Maffeis Angela Zanfardino Ivana Rabbone Sara Giorda Riccardo Schiaffini Antonella Lorubbio Serena Rollato Antonio Iannilli Dario Iafusco Andrea E. Scaramuzza Renee Bowers Rosaria Gesuita
author_facet	Valentino Cherubini Monica Marino Marco Marigliano Claudio Maffeis Angela Zanfardino Ivana Rabbone Sara Giorda Riccardo Schiaffini Antonella Lorubbio Serena Rollato Antonio Iannilli Dario Iafusco Andrea E. Scaramuzza Renee Bowers Rosaria Gesuita
author_sort	Valentino Cherubini
title	Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes
title_short	Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes
title_full	Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes
title_fullStr	Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes
title_full_unstemmed	Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes
title_sort	rethinking carbohydrate intake and time in range in children and adolescents with type 1 diabetes
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/74f36fed965840c48887f0a130d57a70
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Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes

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