Effectiveness of medical nutrition therapy in adolescents with type 1 diabetes: a systematic review
Por:
Granado-Casas, M, Sola, I, Hernandez, M, Rojo-Lopez, MI, Julve, J, Mauricio, D
Publicada:
22 abr 2022
Resumen:
BACKGROUND Medical nutrition therapy (MNT) has an integral role in overall diabetes management. During adolescence, consideration of physiological and psychosocial changes is essential for implementing an optimal diabetes treatment. OBJECTIVES Our aim was to identify, summarize, and interpret the published literature about MNT in adolescents with type 1 diabetes. METHODS The Medline (PubMed) and EMBASE databases were searched from January 1959 to December 2021. The inclusion criteria were interventional studies with MNT in adolescents with type 1 diabetes with a disease duration over 1 year, including the following outcomes: dietary intake and daily eating patterns (assessed with validated tools, two or more 24 h dietary recall or 3-day dietary records), the diabetes self-management education and support (DSMES), glycemic control, lipid profile and body mass index (BMI). The exclusion criteria were studies without a control group (except for pre-post studies), the lack of randomization and those studies that assessed only a single nutrient, food or meal consumption, as well as reviews, and in-vitro/in-vivo studies. The risk of bias assessment was performed using the Cochrane risk-of-bias tool for randomized trials. A narrative synthesis was performed to present the results. The quality of evidence was assessed with the GRADE guidance. RESULTS From a total of 5377 records, 12 intervention studies (9 RCT and 3 pre-post intervention studies) were included. The data were assessed in order to perform a meta-analysis; however, the studies were too heterogeneous. The studies showed conflicting results about the effectiveness of MNT on dietary pattern, DSMES, glycemic control, lipid profile and BMI. CONCLUSIONS Clinical research studies on the effectiveness of MNT in adolescents with type 1 diabetes are scarce. The limited number of studies with a high risk of bias precludes establishing robust conclusions on this issue. Further research is warranted.
Filiaciones:
Granado-Casas, M:
Inst Salud Carlos III, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Hosp Santa Creu i Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Sant Pau Biomed Res Inst IIB Sant Pau, Barcelona, Spain
Sola, I:
Inst Invest Biomed Sant Pau IIB SANT PAU, Barcelona 08041, Spain
Inst Salud Carlos III, Ctr Biomed Res Epidemiol & Publ Hlth CIBERESP, Madrid, Spain
Hernandez, M:
Univ Lleida, Lleida Inst Biomed Res, Dr Pifarre Fdn IRBLleida, Lleida, Spain
Univ Hosp Arnau Vilanova, Dept Endocrinol & Nutr, Lleida, Spain
Rojo-Lopez, MI:
Hosp Santa Creu i Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Sant Pau Biomed Res Inst IIB Sant Pau, Barcelona, Spain
Julve, J:
Inst Salud Carlos III, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Hosp Santa Creu i Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Sant Pau Biomed Res Inst IIB Sant Pau, Barcelona, Spain
Mauricio, D:
Inst Salud Carlos III, Ctr Biomed Res Diabet & Associated Metab Dis CIBE, Barcelona, Spain
Hosp Santa Creu i Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Sant Pau Biomed Res Inst IIB Sant Pau, Barcelona, Spain
Univ Vic UVIC UCC, Fac Med, Vic, Spain
Green Published, gold, Gold, Green
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