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Insulin pump therapy in children and adolescents: Changes in dietary habits, composition and quality of life

Authors

  • Jessica E Peters,

    1. Department of Dietetics, Monash Medical Centre, Melbourne, Victoria, Australia
    2. Department of Nutrition and Dietetics, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia
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  • Elizabeth Mount,

    Corresponding author
    1. Monash Children's Diabetes Ambulatory Care Service, Melbourne, Victoria, Australia
    • Department of Dietetics, Monash Medical Centre, Melbourne, Victoria, Australia
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  • Catherine E Huggins,

    1. Department of Nutrition and Dietetics, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia
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  • Christine Rodda,

    1. Department of Paediatrics, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia
    2. School of Psychiatry and Psychology, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia
    3. Monash Children's Diabetes Ambulatory Care Service, Melbourne, Victoria, Australia
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  • Mary Anne Silvers

    1. Department of Dietetics, Monash Medical Centre, Melbourne, Victoria, Australia
    2. Department of Nutrition and Dietetics, Monash University, Monash Medical Centre, Melbourne, Victoria, Australia
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  • Conflict of interest: For all authors (JP, EM, CH, CR, MS) no competing financial interests exist.

Correspondence: Ms Elizabeth Mount, Department of Dietetics, Monash Medical Centre, 246 Clayton Road, Clayton, Vic. 3168, Australia. Fax: (+613) 9594 6928; email: elizabeth.mount@southernhealth.org.au

Abstract

Aim

Continuous subcutaneous insulin infusion (CSII) can improve glycaemic control and dietary flexibility compared with conventional insulin therapies. There is little information on whether users are utilising this increased dietary flexibility, and whether dietary quality is affected.

Methods

A pre-post observational study was undertaken in 28 children and adolescents with type 1 diabetes commencing CSII. Meal pattern and dietary composition was examined from 3-day food diaries completed before and 3–6 months after CSII commencement. Participants completed the Diabetes-Specific Quality of Life for Youth Short Form, and body mass index z-score, and glycated haemoglobin were measured. A second posttest was undertaken at 18 months with those who were still on CSII and contactable (n = 18).

Results

Energy and macronutrient intake before and 18 months after CSII commencement were unchanged. Mean snacking events decreased significantly by 1.2 snacks per day (P = 0.009), as did the percentage energy derived from snacks (28.8%, 95% confidence interval (CI) 21.5–36.1 vs. 19.3%, 95% CI 13.2–25.4; P = 0.045). Diabetes-Specific Quality of Life for Youth Short Form score was not significantly affected by pump commencement (25.9 95% CI 18.2–33.6), and body mass index z-score remained similar before and after CSII. Glycated haemoglobin decreased by 0.5% in the 3–6 months following CSII commencement, but was similar to baseline at 18 months.

Conclusions

This study demonstrates that the commencement of CSII did not lead to an abandonment of healthy eating principles, and that patients utilised the increased dietary flexibility to make changes to their snacking pattern.

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