Dietary Intake and Risk of Non-Severe Hypoglycemia in Adolescents with Type 1 Diabetes

Citation

Zhong, Victor W.; Crandell, Jamie L.; Shay, Christina M.; Gordon-Larsen, Penny; Cole, Stephen R.; Juhaeri, Juhaeri; Kahkoska, Anna R.; Maahs, David M.; Seid, Michael; & Forlenza, Gregory P., et al. (2017). Dietary Intake and Risk of Non-Severe Hypoglycemia in Adolescents with Type 1 Diabetes. Journal of Diabetes and Its Complications, 31(8), 1340-1347. PMCID: PMC5526710

Abstract

AIMS: To determine the association between dietary intake and risk of non-severe hypoglycemia in adolescents with type 1 diabetes. METHODS: Type 1 adolescents from a randomized trial wore a blinded continuous glucose monitoring (CGM) system at baseline for one week in free-living conditions. Dietary intake was calculated as the average from two 24-h dietary recalls. Non-severe hypoglycemia was defined as having blood glucose <70mg/dL for >/=10min but not requiring external assistance, categorized as daytime and nocturnal (11PM-7AM). Data were analyzed using logistic regression models.
RESULTS: Among 98 participants with 14,277h of CGM data, 70 had daytime hypoglycemia, 66 had nocturnal hypoglycemia, 55 had both, and 17 had neither. Soluble fiber and protein intake were positively associated with both daytime and nocturnal hypoglycemia. Glycemic index, monounsaturated fat, and polyunsaturated fat were negatively associated with daytime hypoglycemia only. Adjusting for total daily insulin dose per kilogram eliminated all associations. CONCLUSIONS: Dietary intake was differentially associated with daytime and nocturnal hypoglycemia. Over 80% of type 1 adolescents had hypoglycemia in a week, which may be attributed to the mismatch between optimal insulin dose needed for each meal and actually delivered insulin dose without considering quality of carbohydrate and nutrients beyond carbohydrate.

URL

http://dx.doi.org/10.1016/j.jdiacomp.2017.04.017

Reference Type

Journal Article

Year Published

2017

Journal Title

Journal of Diabetes and Its Complications

Author(s)

Zhong, Victor W.
Crandell, Jamie L.
Shay, Christina M.
Gordon-Larsen, Penny
Cole, Stephen R.
Juhaeri, Juhaeri
Kahkoska, Anna R.
Maahs, David M.
Seid, Michael
Forlenza, Gregory P.
Mayer-Davis, Elizabeth J.

PMCID

PMC5526710

ORCiD

Gordon-Larsen - 0000-0001-5322-4188