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Nutritional Management of Type 1 Diabetes in Children and Adolescents
Francesca Annan, Paediatric Diabetes Dietitian, Department of Nutrition & Dietetics, Alder Hey Children's NHS Foundation Trust
Introduction The International Society for Paediatric and Adolescent Diabetes1
consensus guidelines chapter on
nutritional management begins with the statement: ‘Nutrition education is one of the cornerstones of diabetes management’. Paediatric dietitians working with children and young people (CYP) with Type 1 diabetes face the challenges of using nutrition education to improve overall glycaemic control and reduce the impact of diabetes related complications on future health.
Diabetes management and dietetic support Changes in diabetes management practice in the UK have been influenced by the results of the Diabetes Control and Complications Trial (DCCT)2, 3
and the withdrawal of mixed insulin preparations by
the manufacturers. The role of increased support, education and diet behaviours in the improvement in HbA1c in intensive intervention group is something that must be considered in current clinical practice.4-6
At the present time, we do not have data on the amount 18 | Complete Nutrition Vol.10 No.6 December/January 2010/11
of dietetic time available to the paediatric population. The 5th National Survey of UK Diabetes Services in the UK reported that 93 per cent of the respondents had dietetic support in clinics compared to 37 per cent in 1988.
This, however, does inform us about the
amount of time available to support and educate CYP and families. How to deliver education to best support improved control is being looked at in a number of studies, including KICk-OFF,7
looking at
carbohydrate counting and insulin adjustment education, and CASCADE,8
which is looking at how education is delivered.
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