Diabetes Type 1 (Pediatrics)

Diabetes Type 1 (Pediatrics)

Welcome to the Diabetes Type 1 Pediatric Project

An evidence scoping review was conducted in 2019 to identify and characterize the availability of literature examining nutrition management interventions among children and adolescents living with type 1 diabetes (formerly known as juvenile diabetes). The purpose of this scoping review was to examine the effect of nutrition management interventions and effectiveness of MNT on improving nutrition-related outcomes in children and adolescents living with type 1 diabetes. The results of the scoping review were used as the focus of the systematic review.

Systematic Review

The aim of the systematic review was to examine the effectiveness of nutrition management interventions on AIC in children and adolescents (6-19 years) living with type 1 diabetes. The expert panel focused on the subtopics of dietary patterns, carbohydrate management, diet quality, food insecurity, culturally relevant/responsive nutrition, vitamin D supplementation, medical nutrition therapy, and macronutrient consumption.

Key Findings: 

  • Overall, there was limited available evidence for most of the topics listed above.
  • Limited evidence reports that weekly medical nutrition therapy sessions for the first month after diagnosis and monthly sessions thereafter may reduce A1C.
  • Very low-quality evidence indicates that improvements in diet quality (HEI score) may be associated with better glycemic outcomes.
  • The effects of dietary patterns like Mediterranean, DASH, and low glycemic index on glycemic outcomes are inconclusive.
  • Carbohydrate counting can be an effective strategy to help reduce and provide continued maintenance of A1C goals.
  • Very low-quality evidence indicates that culturally relevant/responsive nutrition intervention increases the ability to achieve improvements in A1C target and the occurrence of adverse events.
  • Very low-quality evidence indicates low socioeconomic status and lower maternal education are associated with poor glycemic outcomes and increased occurrence of adverse events, such as diabetic ketoacidosis, hospitalization, and emergency room calls and visits.

Use the link on the left to view the systematic review including the research questions, search criteria, evidence summaries, and corresponding tables. 

Evidence-Based Nutrition Practice Guideline

The development of an evidence-based guideline is in progress and is expected to be completed in January 2024. 

Expand the section below titled Project Team and Disclosures for a listing of individuals who contributed to the development of the review, disclosures, and project funding information. 
 

  • Systematic Review Project Team and Disclosures (2023)

    Type 1 Diabetes Mellitus (Pediatrics)
    Project Team and Disclosures

    The following individuals contributed their valuable time and expertise to this project:

    Workgroup Members

    • Becky Sulik, RDN, LD, CDCES, Chair 
      Director of Education, Rocky Mountain Diabetes Center, Idaho Falls, ID, USA
    • Catherine Rogers McManus, PhD, RDN, LD, Vice-Chair
      Assistant Professor, Case Western Reserve University, Cleveland, OH, USA
    • Stefanie Leniszewski, MS, RDN, CD, CDCES
      Clinical Diabetes Specialist, Tandem Diabetes Care, Duvall, WA, USA
    • Kasey M. Metz, MS, RDN, LD, CDCES
      Clinical Dietitian, Dayton Children’s Hospital, Dayton, OH, USA
    • Ariela B. Nielson, MS, RD, CDCES
      Founder and Diabetes Educator, Nielson Nutrition & Diabetes Care, Portland, OR, USA
    • Meg Salvia, MS, RDN, CDC, CEDRD-S
      Owner, Meg Salvia Nutrition, Cambridge, MA, USA

    Project Leaders

    • Deepa Handu, PhD, RD, Project Manager and Methodologist
      Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
    • Erica K. Gradwell, MS, RD, Lead Analyst 
      Consultant Dietitian, Arvada, Colorado, USA
    • Amanda Wanner, MLS, AHIP, Information Specialist
      Consultant, Saint John, NB, Canada

    Evidence Analysts

    • Lyanne Chin, PhD, RD, Garden, CA, USA
    • Kay Howarter, MS, RD, West Lafayette, IN, USA
    • Amy Huang, Basel, Switzerland
    • Telma Moreira, MS, RD, CSO, CNSC, Houston, TX, USA
    • Megan Piotrowski, MS, BSN, RN, CHES, Grosse Point Farms, MI, USA
    • Helen Solomon, MBA, RD, Wilwood, MO, USA
    • Jinyu Xu, MPH, RD, Columbus, OH, USA

    Financial Contributors

    • Academy of Nutrition and Dietetics
    • Academy of Nutrition and Dietetics Foundation
    • Diabetes Care and Education Dietetic Practice Group
       

    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.

    • Sulik: received chair stipend for serving on the Certification Board for Diabetes Care & Education; received compensation from Military Families Learning Network, Alaska Native Hospital, and JDRF PEAK programs for a total of 7 presentations; received travel and meeting expense reimbursement for Certification Board for Diabetes Care & Education; fees paid for training patients/clients on insulin pumps for Insulet Corporation, Medtronic Diabetes, and Tandem Diabetes.
    • McManus: PI/Co-PI on a grant funded by the American Diabetes Association; Case Western Reserve University School of Medicine.
  • Scoping Review Project Team and Disclosures (2019)

    The following individuals contributed their valuable time and expertise to the Diabetes Type 1 Pediatrics Scoping Review:

    Project Team

    • Deepa Handu, PhD, RDN, Project Manager and Methodologist
      Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
    • Megan Piotrowski, MS, RN, Lead Analyst
      Shriners Hospital for Children,, Cincinnati, OH, USA


    Content Advisors

    • Erin Phillips, MPH, RDN, CDE
      Erin Phillips Nutrition, LLC, Seattle, WA, USA
    • Amy Poelker, MS, RD, CDE
      Dietitian Diabetes Educator, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA


    Financial Contributors

    • Diabetes Dietetic Practice Group
    • Academy of Nutrition and Dietetics Foundation
    • Academy of Nutrition and Dietetics


    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members and content advisors have with companies that sell products or services that are relevant to this topic. Workgroup members and content advisors are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have adverse impact on the content, but they are noted here to fully inform readers:

    • None of the content advisors listed above disclosed potential conflicts.