In the Journals

Behavioral intervention improves diet quality in type 1 diabetes

Adolescents with type 1 diabetes assigned to a behavioral intervention had improvements in diet quality without increasing disordered eating behavior, study data show.

Miriam H. Eisenberg Colman, PhD, of the health behavior branch in the division of intramural population health research at Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues evaluated 90 adolescents (mean age, 13.7 years; 51.1% girls; 91% white) with type 1 diabetes (mean duration of diabetes, 6.7 years) to determine whether the effect of an 18-month behavioral intervention is associated with increased disordered eating behavior and the associations of disordered eating behavior with biomarkers of glycemic control and variability in treatment.

Participants assigned to the intervention group (n = 42) attended nine in-person sessions with trained research personnel that included behavioral techniques and education content to promote increased consumption of fruits, vegetables, whole grains and legumes. The final three sessions focused on challenges specific to social eating, meal planning and the food environment. The remaining 48 participants were assigned to a control group that did not focus on the dietary intervention.

Glycemic control measures were obtained at baseline, 6, 12 and 18 months. Participants completed the Diabetes-Management Questionnaire to report on adherence to diabetes-management tasks and as well as the Diabetes Eating Problem Survey-Revised (DEPS-R) to assess disordered eating behavior.

No differences were observed between the intervention and control groups for DEPS-R scores at any assessment period and no within-group differences were observed for DEPS-R scores from baseline to any assessment period.

Poorer glycemic control (P = .001), lower 1,5-anhydroglucitol (P = .01), higher mean sensor glucose (P = .001), percent of sensor glucose values greater than 180 mg/dL (P < .001) and poorer diabetes management (P = .03) were all associated with higher DEPS-R scores. No association was observed between DEPS-R and standard deviation of the mean sensor glucose, percent of sensor glucose values less than 70 mg/dL or mean amplitude of glycemic excursions.

Participants with higher DEPS-R scores at baseline were more likely to have mean sensor glucose and percent of sensor glucose values greater than 180 mg/dL compared with participants with lower DEPS-R scores at baseline.

“This study demonstrated the feasibility of improving diet quality without adversely impacting [disordered eating behavior] among adolescents with type 1 diabetes,” the researchers wrote. “Findings also showed an association of [disordered eating behavior] with sustained hyperglycemic rather than glycemic variability or hypoglycemia. Finally, results demonstrate that even at the subclinical levels seen in this sample, [disordered eating behavior] can hinder glycemic control during adolescence, emphasizing the importance of further research and early interventions to reduce these behaviors.” – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.

Adolescents with type 1 diabetes assigned to a behavioral intervention had improvements in diet quality without increasing disordered eating behavior, study data show.

Miriam H. Eisenberg Colman, PhD, of the health behavior branch in the division of intramural population health research at Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues evaluated 90 adolescents (mean age, 13.7 years; 51.1% girls; 91% white) with type 1 diabetes (mean duration of diabetes, 6.7 years) to determine whether the effect of an 18-month behavioral intervention is associated with increased disordered eating behavior and the associations of disordered eating behavior with biomarkers of glycemic control and variability in treatment.

Participants assigned to the intervention group (n = 42) attended nine in-person sessions with trained research personnel that included behavioral techniques and education content to promote increased consumption of fruits, vegetables, whole grains and legumes. The final three sessions focused on challenges specific to social eating, meal planning and the food environment. The remaining 48 participants were assigned to a control group that did not focus on the dietary intervention.

Glycemic control measures were obtained at baseline, 6, 12 and 18 months. Participants completed the Diabetes-Management Questionnaire to report on adherence to diabetes-management tasks and as well as the Diabetes Eating Problem Survey-Revised (DEPS-R) to assess disordered eating behavior.

No differences were observed between the intervention and control groups for DEPS-R scores at any assessment period and no within-group differences were observed for DEPS-R scores from baseline to any assessment period.

Poorer glycemic control (P = .001), lower 1,5-anhydroglucitol (P = .01), higher mean sensor glucose (P = .001), percent of sensor glucose values greater than 180 mg/dL (P < .001) and poorer diabetes management (P = .03) were all associated with higher DEPS-R scores. No association was observed between DEPS-R and standard deviation of the mean sensor glucose, percent of sensor glucose values less than 70 mg/dL or mean amplitude of glycemic excursions.

Participants with higher DEPS-R scores at baseline were more likely to have mean sensor glucose and percent of sensor glucose values greater than 180 mg/dL compared with participants with lower DEPS-R scores at baseline.

“This study demonstrated the feasibility of improving diet quality without adversely impacting [disordered eating behavior] among adolescents with type 1 diabetes,” the researchers wrote. “Findings also showed an association of [disordered eating behavior] with sustained hyperglycemic rather than glycemic variability or hypoglycemia. Finally, results demonstrate that even at the subclinical levels seen in this sample, [disordered eating behavior] can hinder glycemic control during adolescence, emphasizing the importance of further research and early interventions to reduce these behaviors.” – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.