Preprandial Insulin and Routine Eating Patterns May Help Children with Type 1 Diabetes Reach Glycemic Targets

Preprandial Insulin and Routine Eating Patterns May Help Children with Type 1 Diabetes Reach Glycemic Targets

-Shahd Husein

Recent findings from a study published in the BMJ Open Diabetes Research & Care journal found that children with type 1 diabetes who take insulin before their meals and typically have routine eating patterns have a greater chance of reaching glycemic targets, according to a Healio report

In a retrospective, cross-sectional study, researchers examined the dietary intake of 22 Australian children below the age of 7 with type 1 diabetes, with the goal of understanding nutritional habits and eating patterns. They measured several factors, including weight, age, HbA1c, method of insulin administration, and duration of diabetes. Researchers also required the parents of participants to keep an extensive three-day diary of the weighed amounts of the food and drink the children consumed, in addition to asking the parents to fill out a mealtime management questionnaire. 

Every participant reportedly ate at least three times per day. Approximately 95% of study participants reported taking preprandial insulin, or insulin administered before a meal, prior to consuming food. 

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Researchers split up dietary intake findings based on whether the parent or child determined the child’s mealtime. Grazing was reported for 18% of participants who were given food ‘whenever hungry,’ notes the study, versus the majority of which parents determined mealtimes. For those in the 18% group, the snacks given during grazing were typically high in saturated fat. 

What the researchers found was that preprandial insulin was instrumental in decreasing postprandial, or post-meal, glycemic excursions. This finding supports the results of a T1D Exchange Clinic Registry study that also cited lower HbA1c levels with preprandial insulin. 

No correlations was found between HbA1c levels and carbohydrate, protein, or fat intake. However, researchers did find an association between higher HbA1c levels and children who grazed, or continuously snacked, during the day in comparison to children who maintained routine eating patterns, according to the study. 

Dr. Rowen Seckold, a lead researcher with John Hunter Children’s Hospital in New South Wales, Australia, also mentioned that consumption of fruits and vegetables remained low among this age group — none of the 22 participants consumed the recommended intakes as proposed by the Australian government — while consumption of saturated fat was high.

Dr. Seckold hopes future research on this topic will include a much larger sample size and a more in-depth look into whether routine mealtimes could help improve the quality of food that participants are consuming.

“The clinical implications of this [study] are that eating in a routine pattern is associated with lower HbA1c, suggesting that avoidance of grazing or continuous snacking is beneficial to diabetes management in this young age group,” said Seckold. “Further research into dietary interventions to improve diet quality in young children is required.”

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