Carbohydrate intake in relation to BMI, HbA1c and lipid profile in children and adolescents with type 1 diabetes

Clin Nutr. 2014 Feb;33(1):75-8. doi: 10.1016/j.clnu.2013.03.017. Epub 2013 Apr 6.

Abstract

Background & aims: To compare reported and recommended carbohydrate intake in children and adolescents with type 1 diabetes (T1D) and to explore associations with BMI, HbA1c and lipid profile.

Methods: A cross-sectional observational study of reported carbohydrate intake in 46,010 patients with T1D aged 1-18 years from 332 diabetes centres in Germany and Austria in comparison to age-matched healthy children and adolescents.

Results: The median reported carbohydrate intake in T1D patients was markedly lower than in healthy children. It varied between 56% and 90% of recommended amounts across the paediatric age range with younger patients showing levels closer to recommend. Lower carbohydrate intake was associated with higher BMI-SDS (p < 0.001), particularly during adolescence, higher total cholesterol (p < 0.001), higher LDL-cholesterol (p = 0.005) and lower HbA1c (p < 0.001).

Conclusions: The methodologically simple measure of reported carbohydrate intake may be a valuable addition to the information gathered on paediatric patients with T1D in an outpatient setting. Children and adolescents with T1D appear to restrict their consumption of carbohydrates, which may have adverse effects on BMI and the lipid profile, particularly if there is a compensatory increased fat intake. Health care providers should therefore advise patients and parents of the recommended age-dependent levels of carbohydrate intake.

Keywords: BMI; CU; Carbohydrate intake; DPV; Diabetes Patienten-Verlaufsdokumentation (diabetes patients observational study); HDL-cholesterol; HbA1c; LDL-cholesterol; Lipid profile; SDS; T1D; Type 1 diabetes; body mass index; carbohydrate unit (1 unit = 10–12 g carbohydrate); glycated haemoglobin A1c; high-density lipoprotein-cholesterol; low-density lipoprotein-cholesterol; standard deviation score; type 1 diabetes.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism
  • Body Mass Index*
  • Child
  • Child, Preschool
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Dietary Carbohydrates / administration & dosage*
  • Female
  • Germany
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Infant
  • Male
  • Triglycerides / blood*

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Dietary Carbohydrates
  • Glycated Hemoglobin A
  • Triglycerides