印度1型糖尿病儿童碳水化合物计数与固定膳食计划:一项随机对照试验。

IF 2.1 4区 医学 Q2 PEDIATRICS
Indian Journal of Pediatrics Pub Date : 2024-12-01 Epub Date: 2023-10-03 DOI:10.1007/s12098-023-04850-z
Rajni Sharma, Babita Upadhyay, Nitika Lal, Rajesh Sagar, Vandana Jain
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引用次数: 0

摘要

目的:研究碳水化合物计数与固定膳食计划对1型糖尿病(T1DM)儿童血糖控制、生活质量(QoL)和糖尿病相关情绪困扰的影响。排除患有乳糜泻、甲状腺功能减退、任何潜在的慢性肾脏/肝脏/全身疾病或HbA1c>13%的患者。两组都接受了糖尿病管理和健康饮食方面的教育。在干预组中,父母被教导量化碳水化合物含量,并根据胰岛素-碳水化合物比例修改胰岛素剂量。对照组根据推荐的饮食量和食物交换清单制定饮食处方。使用标准验证问卷来评估与糖尿病相关的生活质量和情绪困扰。结果:125名患者(61名干预组,64名对照组)入选,分别有91.8%和84.3%的患者完成了6个月的随访。两组的HbA1c都有所下降,但在组内或组间没有统计学意义{干预组:8.9(1.4)至8.6(1.5)vs.对照组:9.1(1.6)至8.8(1.9),[95%CI 8.3-9.3vs.8.3-9.0,意向治疗(ITT),p=0.63]。干预组的糖尿病痛苦显著减少;DAWN糖尿病问题领域问卷(PAID)得分,中位数(四分位间距)为21(11-33),对照组为27(20-40),(p=0.04)。结论:与固定膳食计划相比,碳水化合物计数组的患者在6个月内表现出较低的糖尿病困扰得分和较少的情绪倦怠,尽管两组之间的总体血糖控制具有可比性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carbohydrate Counting vs. Fixed Meal Plan in Indian Children with Type 1 Diabetes Mellitus: A Randomized Controlled Trial.

Objectives: To study the impact of carbohydrate counting vs. fixed-meal plan on glycemic control, quality of life (QoL) and diabetes-related emotional distress in children with Type 1 diabetes mellitus (T1DM).

Methods: Children aged 6-18 y with T1DM of duration >1 y were eligible for the study if they were on multiple daily injections of insulin and regularly monitoring blood glucose. Those with celiac disease, hypothyroidism, any underlying chronic renal/liver/systemic disease or HbA1c >13% were excluded. Both groups received education on diabetes management and healthy diet. In the intervention arm, parents were taught to quantify carbohydrate content and modify insulin doses according to insulin-carbohydrate ratio. The control arm had dietary prescription according to recommended dietary allowance and food exchange list. Standard validated questionnaires were used to assess the QoL and emotional distress related to diabetes.

Results: One hundred twenty five patients (61 intervention, 64 controls) were enrolled and 91.8% and 84.3%, respectively, completed 6-mo follow-up. There was a reduction in HbA1c in both the groups, but was not statistically significant within or between groups {Intervention: 8.9 (1.4) to 8.6 (1.5) vs. control: 9.1 (1.6) to 8.8 (1.9), [95% CI 8.3-9.3 vs. 8.3-9.0, intention to treat (ITT), p = 0.63]}. There was a significant reduction in diabetes distress in the intervention group; DAWN Problem Areas in Diabetes Questionnaire (PAID) score with a median (interquartile range) of 21 (11-33) vs. control: 27 (20-40), (p = 0.04).

Conclusions: Patients in the carbohydrate-counting group demonstrated lower diabetes distress scores and less emotional burnout compared to fixed-meal plan over a 6 mo period though overall glycemic control was comparable between groups.

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来源期刊
Indian Journal of Pediatrics
Indian Journal of Pediatrics 医学-小儿科
CiteScore
8.10
自引率
7.00%
发文量
394
审稿时长
3-6 weeks
期刊介绍: Indian Journal of Pediatrics (IJP), is an official publication of the Dr. K.C. Chaudhuri Foundation. The Journal, a peer-reviewed publication, is published twelve times a year on a monthly basis (January, February, March, April, May, June, July, August, September, October, November, December), and publishes clinical and basic research of all aspects of pediatrics, provided they have scientific merit and represent an important advance in knowledge. The Journal publishes original articles, review articles, case reports which provide new information, letters in relation to published articles, scientific research letters and picture of the month, announcements (meetings, courses, job advertisements); summary report of conferences and book reviews.
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