Type 1 Diabetes Mellitus (Pediatrics) Evidence-Based Nutrition Practice Guideline

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases among children and adolescents in the U.S., with a notable rise over the past two decades. The Academy recently published new guidelines for registered dietitian nutritionists (RDNs) offering medical nutrition therapy (MNT) to children and adolescents ages 6 to 19 with T1DM. The new Type 1 Diabetes Mellitus (Pediatrics) Evidence-Based Nutrition Practice Guideline is available as a member benefit via the Academy's Evidence Analysis Library^® to direct evidence-based nutrition practice.

The guidelines address several key areas including:

• Dietary Patterns: The guideline explores effects of specific dietary patterns, such as the Mediterranean, DASH and low glycemic index diets.
• Carbohydrate Management: Evidence suggests that certain carbohydrate management strategies may offer small improvements in quality-of-life scores and overall confidence in prescribed dietary advice compared to other methods.
• Diet Quality: Limited evidence indicates that improvements in diet quality may be associated with better glycemic outcomes in this population.
• Food Insecurity: The guidelines examine the association between food insecurity and glycemic control, acknowledging the challenges faced by food-insecure families in managing T1DM.
• Culturally Relevant Nutrition: The importance of culturally responsive nutrition interventions is highlighted.
• Vitamin D Supplementation: The guidelines review the role of vitamin D supplementation in glycemic control among youth with T1DM.
• MNT: Limited evidence shows that weekly MNT sessions for the first month after diagnosis and monthly sessions thereafter may reduce A1C levels in children and adolescents with T1DM.
• Macronutrient Consumption: There is a lack of research examining the effect of differing amounts of macronutrient consumption in youth with T1DM on nutrition-related outcomes.

Overall, the guidelines emphasize the need for individualized nutrition interventions and highlights areas where further research is necessary to optimize care for pediatric patients with T1DM. Personalized MNT is a specialty of RDNs who can help young people with T1DM and their families implement healthful eating practices to support blood sugar control, helping to reduce complications and potentially save health care dollars.

Learn more about the guidelines and associated resources. The development of this guideline was funded by the Diabetes Care and Education Dietetic Practice Group via the Academy of Nutrition and Dietetics Foundation.