Association between factors related to food and treatment, with glycemic control and the nutritional status of patients with type 1 diabetes mellitus users of continuous insulin infusion pump

Authors

  • Renata Cristina Machado Mendes Universidade Federal do Ceará
  • Natasha Vasconcelos Albuquerque
  • Renan Magalhães Montenegro Júnior Universidade Federal do Ceará
  • Maria Yasmin Paz Teixeira Martins Universidade Federal de Campina Grande/Hospital Universitário Júlio Bandeira
  • Carolina Maria Teixeira dos Santos Porto Centro Universitário Estácio do Ceará
  • Amanda Câmara Nunes Universidade Federal do Ceará
  • Carla Soraya Costa Maia Universidade Estadual do Ceará
  • Samila Torquato Araújo Universidade Federal do Ceará

DOI:

https://doi.org/10.12873/421machado

Keywords:

Diabetes mellitus, type 1, Glycemic control, Insulin infusion systems, Nutritional status

Abstract

Introduction: Adequate glycemic control and nutritional status are allies in the treatment and health promotion of patients with type 1 diabetes mellitus (T1DM). Objective: To investigate the association between factors related to food and T1DM treatment with glycemic control and nutritional status in patients using insulin pumps. Materials and Methods: Cross-sectional study with 61 patients from Ceará. Through the REDCap tool, socioeconomic, glycemic control, anthropometric and diabetes-related data, treatment and diet were collected. Data from SICI's and glucose sensors were also uploaded. Pearson's Chi-Square, Fisher's Exact and Spearman's correlation tests were applied, with a significance level of 5%. Results: Overweight was associated with difficulty to waiting for the insulin action time before feeding (p=0.048) and less difficulty with lack of supply of inputs (p=0.040). Not being overweight was associated with physical exercise (p<0.001), less belief that insulin contributes to weight gain (p<0.001), and less concern about it (p=0.024). Those with adequate glycated hemoglobin and glucose standard deviation (SD) attended the nutritionist more often (p=0.041; p=0.007), those with an adequate coefficient of variation (CV) had more than 10 years of disease (p=0.001) and those with an adequate PD and VC, had less difficulty in performing bolus in public (p=0.044; p=0.001) and measured blood glucose four or more times daily (p=0.033; p=0.030). Conclusion: Nutritional status and glycemic control are associated with individual patient factors, highlighting the importance of health professionals' understanding and management of these factors.

References

Sociedade Brasileira de Diabetes (SBD). Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. São Paulo: Clannad; 2019.

International Diabetes Federation (IDF). IDF Atlas. 10 ed. Bruxelas: International Diabetes Federation; 2021.

American Diabetes Association (ADA). Standards of Medical Care in Diabetes – 2021. Diabetes Care 2021; 44(Suppl 1).

Beck RW, Bergenstal RM, Laffel LM, Pickup JC. Advances in technology for management of type 1 diabetes. Lancet. 2019; 394(10205):1265-73, doi: 10.1016/S0140-6736(19)31142-0.

Battelino T, Danne T, Bergenstal RM, Amiel AS, Beck R, Biester T, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range. Diabetes Care. 2019; 42(8):1593-603, doi: 10.2337/dci19-0028.

Nimri R, Nir J, Phillip M. Insulin Pump Therapy. Am J Ther. 2020; 27(1):e30-e41, doi: 10.1097/MJT.0000000000001097.

Steinke TJ, O’Callahan EL, York JL. Role of a registered dietitian in pediatric type 1 and type 2 diabetes. Transl Pediatr. 2017; 6(4):365-72, doi: 10.21037/tp.2017.09.05.

Dahlström EH, Sandholm N, Forsblom CM, Thorn LM, Jansson FJ, Harjutsalo V, Groop P. Body Mass Index and Mortality in Individuals With Type 1 Diabetes. J Clin Endocrinol Metab. 2019; 104(11):5195-5204, doi:10.1210/jc.2019-00042.

Carneiro LBV, Lacerda EMDA, Medeiros da Costa V, Luiz Luescher J, Fontes De Lima GC, Berardo Szundy R. Perfil lipídico de crianças e adolescentes com Diabetes Mellitus tipo 1. Nutr Clin y Diet Hosp, 2017; 37(4):23-8. doi: 10.12873/374carneiro.

Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017; 377(1):13–2, doi: 10.1056/NEJMo a1614362.

Bussab WO, Morettin PA. Estatística Básica. 8 ed. São Paulo: Saraiva; 2013.

Brasil. Ministério da Saúde (MS). Resolução Nº 466/2012, de 12 de dezembro de 2012. Diretrizes e Normas Regulamentadoras de Pesquisas Envolvendo Seres Humanos (Conselho Nacional de Saúde). Diário Oficial da União 2012; 12 dez.

World Health Organization (WHO). Obesity: preventing and managing the global epidemic. Geneva: WHO; 1998. (Report of a WHO Consultation on Obesity).

De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):6607, doi: 10.2471/blt.07.043497.

Sociedade Brasileira de Diabetes (SBD). Diretriz 2021 Sociedade Brasileira de Diabetes: Versão Preliminar. São Paulo: SBD; 2021.

Fellinger P, Fuchs D, Wolf P, Heinze G, Luger A, Krebs M, et al. Overweight and obesity in type 1 diabetes equal those of the general population. Wien Klin Wochenschr, 2019; 131(3-4):55-60, doi: 10.1007/s00508-018-1434-9.

Goldberg T, Brener A, Levy S, Interator H, Laurian I, Dorfman A, et al. Association between age at type 1 diabetes diagnosis and metabolic outcome at young adulthood: a real-life observational study. Diabetes Metab Res Ver. 2021; 37(1):e3356, doi: 10.1002/dmrr.3356.

Beck RW, Connor CG, Mullen DM, Wesley DM, Bergenstal RM. The fallacy of average: how using HbA1c alone to assess glycemic control can be misleading. Diabetes Care. 2017; 40(8):994–9, doi: 10.2337/dc17-0636.

Julla JB, Jacquemier P, Fagherazzi G, Vidal-Trecan T, Juddoo V, Jaziri A, et al. Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?. Diabetes Care. 2021; 44(7):1722-5, doi: 10.2337/dc20-1847.

Sun B, Luo Z, Zhou J. Comprehensive elaboration of glycemic variability in diabetic macrovascular and microvascular complications. Cardiovasc Diabetol. 2021;20(1):9. Published 2021 Jan 7. doi:10.1186/s12933-020-01200-7.

Polonsky WH. Psychosocial Aspects of Diabetes Technology: Adult Perspective. Endocrinol Metab Clin North Am. 2020; 49(1):14355, doi: 10.1016/j.ecl.2019.10.003.

Schnell O, Klausmann G, Gutschek B, Garcia-Verdugo RM, Hummel M. Impact on Diabetes Self-Management and Glycemic

Control of a New Color-Based SMBG Meter. J Diabetes Sci Technol. 2017;11(6):1218-25, doi: 10.1177/1932296817706376.

Due-Christensen M, Zoffmann V, Willaing I, Hopkins D, Forbes A. The Process of Adaptation Following a New Diagnosis of Type 1 Diabetes in Adulthood: A Meta-Synthesis. Qual Health Res. 2018; 28(2):245-58, doi: 10.1177/1049732317745100.

Pickup JC. Is insulin pump therapy effective in Type 1 diabetes?. Diabet Med. 2019; 36(3):269-78, doi: 10.1111/dme.13793.

Kurtović A, Vuković I, Gajić M. The Effect of Locus of Control on University Students’ Mental Health: Possible Mediation through Self-Esteem and Coping. J Psychol. 2018; 152(6):341-57, doi:

1080/00223980.2018.1463962.

Corbin KD, Driscoll KA, Pratley RE, Smith RS, Maahs DM, MayerDavis EJ, et al. Obesity in Type 1 Diabetes: Pathophysiology, Clinical Impact, and Mechanisms. Endocr Ver. 2018; 39(5):629663, doi: 10.1210/er.2017-00191.

Štotl I, Kambič T, Hadžić V, Zdolšek A. Different Types of Physical Activity and Metabolic Control in People With Type 1 Diabetes Mellitus. Front Physiol. 2019; 10:1210, doi: 10.3389/fphys.2019 .01210.

Instituto Brasileiro de Geografia e Estatistica (IBGE). Pesquisa de Orçamentos Familiares 2017-2018: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2020.

Vilar L. Endocrinologia Clínica. 7 ed. Rio de Janeiro: Guanabara Koogan; 2020.

Edqvist J, Rawshani A, Adiels M, Björck L, Lind M, Svensson A, et al. BMI, Mortality, and Cardiovascular Outcomes in Type 1 Diabetes: Findings Against an Obesity Paradox. Diabetes Care. 2019; 42(7):1297-304, doi: 10.2337/dc18-1446.

Polonsky WH, Anderson BJ, Lohrer RA, Aponte JE, Jacobson AM,

Cole CF. Insulin omission in women with IDDM. Diabetes Care. 1994; 17(10):1178–85, doi: 10.2337/diacare.17.10.1178.

Troncone A, Cascella C, Chianese A, Zanfardino A, Piscopo A, Borriello A, Casaburo F, Del Giudice EM, Iafusco, D. Body Image

Problems and Disordered Eating Behaviors in Italian Adolescents With and Without Type 1 Diabetes: An Examination With a

Gender-Specific Body Image Measure. Front Psychol. 2020; 11:556520. doi:10.3389/fpsyg.2020.556520.

Hanna KM, Weaver MT, Slaven JE, Stump TE, Shieh C. Weight control behaviors among emerging adults with type 1 diabetes. Diabetes Educ. 2015; 41(4):444-51, doi: 10.1177/0145721715 581667.

DuBose SN, Hermann JM, Tamborlane WV, Beck RW, Dost A, DiMeglio LA, et al. Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States. J Pediatr. 2015; 167(3):627-32.e324, doi: 10.1016/j.jpeds.2015.05.046.

Jain SR, Sui Y, Ng CH, Chen ZX, Goh LH, Shorey S. Patients’ and healthcare professionals’ perspectives towards technology-assisted diabetes self-management education: A qualitative systematic review. PLoS One. 2020; 15(8):e0237647, doi: 10.1371/journal.pone.0237647.

Adolfsson P, Hartvig NV, Kaas A, Møller JB, Hellman J. Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen. Diabetes Technol Ther. 2020; 22(10):709-18, doi: 10.1089/dia.2019.0411.

Published

2022-04-18

How to Cite

Machado Mendes, R. C., Natasha Vasconcelos Albuquerque, Renan Magalhães Montenegro Júnior, Maria Yasmin Paz Teixeira Martins, Carolina Maria Teixeira dos Santos Porto, Amanda Câmara Nunes, … Samila Torquato Araújo. (2022). Association between factors related to food and treatment, with glycemic control and the nutritional status of patients with type 1 diabetes mellitus users of continuous insulin infusion pump. Nutrición Clínica Y Dietética Hospitalaria, 42(01). https://doi.org/10.12873/421machado

Issue

Section

Research articles

Categories

Most read articles by the same author(s)