Dietary intake, diet-related knowledge and metabolic control of children with type 1 diabetes mellitus, aged 6-10 years attending the paediatric diabetic clinics at Grey's Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal.
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Date
2007
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Abstract
The aim of this study was to assess the dietary intake, diet-related knowledge and
metabolic control in children with Type 1 Diabetes Mellitus between the ages of 6-10 years
attending the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi
Albert Luthuli Central Hospital, Durban, KwaZulu-Natal.
This was a cross sectional observational study that was carried out in a total of 30 subjects
out of a possible 35 subjects that qualified for inclusion in the study from both the Grey’s
Hospital clinic (n=8) and IALCH clinic (n=22).
The dietary intake was assessed in a total of 25 subjects using a three day dietary record
(n=20) and a 24 hour recall of the third day of the record (n=16). Diet-related knowledge
was assessed using a multiple choice questionnaire. Metabolic control was assessed using
the most recent HbA1c and the mean HbA1c results over the previous 12 months from the
date of data collection. Height and weight measurements were also carried out.
Information on socioeconomic status and education status of the caregivers was obtained
from 22 caregivers through follow-up phone calls. All measurements except for dietary
intake were obtained from all subjects participating in the study.
The mean percentage contribution of macronutrients to total energy was very similar to the
International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus
Guidelines (2002). The mean percentage contribution of macronutrients to total energy
from the 3 day dietary records and the 24 hour recalls were as follows: carbohydrate (52%
and 49%); sucrose (2% and 2%); protein (16% and 17%); fat (32% and 34%).
Micronutrient intake was adequate for all micronutrients except for calcium and vitamin D
which showed low intakes.
The mean diet-related knowledge score for the sample was 67% with significantly higher
scores in children older than 8 years of age.
The latest HbA1c for the sample was 9.7% and the mean HbA1c over the previous 12
months from the date of data collection was 9.6%. There was a significant positive
correlation between age of the participant and the latest HbA1c (r = 0.473; p=0.008) and a
significant negative correlation between the education level of the caregivers and the latest
HbA1c (r = - 0.578; p=0.005) and the mean HbA1c over 12 months (r = - 0.496; p=0.019).
Significant differences were found between African and Indian children respectively for
HbA1c, with higher values in African children. There was no correlation between BMI for
age and latest HbA1c (r = 0.203, p=0.282) or mean HbA1c over 12 months (r = 0.101,
p=0.594). Z score for BMI for age was also not correlated with latest HbA1c (r = 0.045,
p=0.814) or mean HbA1c over 12 months (r = - 0.012, p=0.951). Children from the Grey’s
Hospital Clinic were found to have higher HbA1c values (p=0.001) and lower diet-related
knowledge scores as compared to the children from the IALCH Clinic (p=0.038). It should
be noted that the ethnic and racial composition of the children attending these two clinics
differed.
In conclusion the macronutrient intake in this sample was found to be similar to the ISPAD
Consensus Guidelines (2002) while calcium and vitamin D intakes were low. Overall this
sample displayed good diet-related knowledge while metabolic control was found to be
poor.
Description
Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.
Keywords
Diabetes in children--Nutritional aspects., Diabetes in children--Diet therapy., Diabetes in children--KwaZulu-Natal--Case studies., Diabetes in children--South Africa--Nutritional aspects., Diabetes in children--Treatment, Children--Diseases--Nutritional aspects., Diabetes--Nutritional aspects., Nutrition--Evaluation., Nutrition--Requirements., Diabetes--Treatment., Theses--Dietetics and human nutrition.