Aim: Most youth with T1D meet neither nutrition guidelines nor glycemic goals. We assessed macronutrient content of meals/snacks and impact of daily number of meals/snacks on glycemic outcomes in youth with T1D over 1 year.
Methods: Youth completed 3-day food records (2 week days/1 weekend day) and wore 3-day masked CGM (iPro™) every 3 months for 1 year. Diet data were reviewed by 2 RDs and analyzed using Nutrition Data System for Research (NDSR). Glycemic outcomes were A1c and CGM metrics (glucose % time in range [TIR] 70-180 mg/dL, % time [T] <70, %T>180, and glucose CV [SD/mean]). Longitudinal mixed models assessed effect of number of daily meals/snacks on glycemic outcomes.
Results: Youth (N=136, ages 8-17, 48% male) were ages 12.8±2.5 years with T1D duration 5.9±3.1 years and daily insulin dose 0.9±0.3 U/kg; 73% used insulin pumps. Number of meals/snacks ranged from 1-9 with most youth (69%) reporting 3-4 meals/snacks daily. Macronutrient intake varied by meal/snack (Figure). An increase of 1 meal/snack per day led to a 0.1% decrease in A1c (p=.001), 2.4% (35 minutes/day) more TIR (p=.0006), and 3.1% (45 minutes/day) less T>180 (p=.0001); T<70 and CV were unchanged.
Conclusions: In youth with T1D, eating frequent meals/snacks may lead to lower A1c, more TIR, and less hyperglycemia. These findings may be due to dividing energy intake across the day with more frequent bolus dosing, given predominance of carbohydrates in meals/snacks.
R.O. La Banca: None. L.K. Volkening: None. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. S.N. Mehta: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US.
National Institutes of Health (P30DK036836, K12DK094721)