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Blood Glucose Variability in Relation to Eating Frequency, Composition, and Meal Size in Adolescents with Type 1 Diabetes Following a DASH Dietary Pattern

Maco, Kimberly
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470753751

Abstract Details

2016, MS, University of Cincinnati, Allied Health Sciences: Nutrition.
Background: Glycemic variability (GV) is a contributor to cardiovascular disease (CVD) and related to complications in individuals with type 1 diabetes mellitus (T1DM). Research suggests that GV may be reduced through increased frequency of eating occasions and increased intake of soluble fiber, protein and fat at meals; this dietary composition aligns well with the Dietary Approaches to Stop Hypertension (DASH) diet recommendations. Objective: The objective of this study was to determine whether GV of adolescents with T1DM using continuous insulin infusion was related to the composition, size, and frequency of eating occasions when following a diet compliant with the DASH dietary pattern or their usual intake. Methods: Nine adolescent patients (10-17 years of age), both male and female, with T1DM consumed their usual diet (based on carbohydrate (CHO) counting) and then a diet compliant with the DASH dietary pattern while wearing a continuous glucose monitoring (CGM) system for 3 days each. A DASH diet prescription was determined for each patient and meals were designed to comply with these specifications. Dietary components (i.e. macronutrient composition and quantity, total and dietary fiber, and energy), eating occasion frequency (total number of eating occasions), and CGM data of each 3-day period were assessed. Each dietary component variable was calculated as the average of all eating occasions during the study period. CGM data measured the temporal glucose fluctuations at 5-minute increments. GV, calculated from the CGM data, was determined based on established metrics: continuous overlapping net glycemic action (CONGA), standard deviation (SDt), and index of glycemic action (IGC). Confounding variables included in the statistical analysis were age, BMI percent, and HbA1c. Results: Glycemic variability, during the DASH diet period only, was inversely related to total dietary fiber (SDt, (ß=-69.84, p=0.024) and CONGA (ß=-1.56, p=0.09)) and soluble fiber (CONGA (ß=-3.31, p=0.031); SDt (ß=-127.28, p=0.045); IGC (ß=-3.14, p=0.092)). Additionally, GV, during the DASH diet period only, was inversely related to percent fat of eating occasions (CONGA (ß=-0.176, p=0.02); IGC (ß=-0.217, p=0.078); SDt (ß=- 5.49, p=0.013)), and showed a positive trend with percent carbohydrate of eating occasions (CONGA (ß=0.141, p=0.053); IGC (ß=0.197, p=0.061); SDt (ß=3.909, p=0.096)). As expected, total and soluble fiber intakes were higher on the DASH diet compared to the usual intake period (p<0.001 for both). There were no associations between the quantity or size of eating occasions and GV measures. Conclusion: In conclusion the composition of meals on a diet compliant with the DASH dietary pattern, specifically total fiber, soluble fiber, and fat may favorably impact (reduce) blood glucose variability in youth with T1DM.
Abigail Peairs, Ph.D. (Committee Chair)
Sarah Couch, Ph.D. (Committee Member)
62 p.
Nutrition
DASH diet; meal patterning; glycemic variability; meal frequency; meal composition; meal size

Recommended Citations

Citations

  • Maco, K. (2016). Blood Glucose Variability in Relation to Eating Frequency, Composition, and Meal Size in Adolescents with Type 1 Diabetes Following a DASH Dietary Pattern [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470753751

    APA Style (7th edition)

  • Maco, Kimberly. Blood Glucose Variability in Relation to Eating Frequency, Composition, and Meal Size in Adolescents with Type 1 Diabetes Following a DASH Dietary Pattern. 2016. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470753751.

    MLA Style (8th edition)

  • Maco, Kimberly. "Blood Glucose Variability in Relation to Eating Frequency, Composition, and Meal Size in Adolescents with Type 1 Diabetes Following a DASH Dietary Pattern." Master's thesis, University of Cincinnati, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470753751

    Chicago Manual of Style (17th edition)

ucin1470753751
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This open access ETD is published by University of Cincinnati and OhioLINK.