Nutrition Interventions for Pediatric Individuals with Type 1 Diabetes

A systematic review was conducted to examine the effectiveness of nutrition interventions on hemoglobin A1C in children and adolescents living with Type 1 diabetes. Overall, there was limited available evidence for most of the nutrition intervention topics.

Available evidence indicates that:

• weekly medical nutrition therapy sessions for the first month after diagnosis and monthly sessions thereafter may reduce A1C;
• carbohydrate counting can be an effective strategy to help reduce and provide continued maintenance of A1C goals;
• effects of dietary patterns such as Mediterranean, DASH and low glycemic index on glycemic outcomes are inconclusive;
• very low quality evidence indicates that improvements in diet quality (Healthy Eating Index) and culturally relevant or responsive nutrition interventions increase the ability to achieve improvements in A1C targets and occurrence of adverse events;
• and very low quality evidence indicates that low socioeconomic status and lower maternal education are associated with poor glycemic outcomes and increased occurrence of adverse events.

The findings from this systematic review and other important factors including balance of harms and benefits, client values, health equity, resource use, acceptability and feasibility, and clinical expertise will guide the expert panel to develop diabetes management recommendations that take into consideration children and adolescents’ developmental and psychosocial needs and work in collaboration with their families.

This systematic review was funded by the Academy of Nutrition and Dietetics, the Academy Foundation and the Academy’s Weight Management Dietetic Practice Group. View the full systematic review.