Effectiveness of medical nutrition therapy in adolescents with type 1 diabetes : a systematic review
Granado-Casas, Minerva (Institut d'Investigació Biomèdica Sant Pau)
Solà, Ivan (Institut d'Investigació Biomèdica Sant Pau)
Hernández García, Marta (Hospital Universitari Arnau de Vilanova)
Rojo López, Marina Idalia (Institut d'Investigació Biomèdica Sant Pau)
Julve i Gil, Josep (Institut d'Investigació Biomèdica Sant Pau)
Mauricio, Didac (Institut d'Investigació Biomèdica Sant Pau)

Data:	2022
Resum:	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.
Nota:	Altres ajuts: CIBERDEM is an initiative from Instituto de Salud Carlos III (Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Adolescent ; Diabetes Mellitus, Type 1 ; Diet ; Feeding Behavior ; Humans ; Lipids ; Nutrition Therapy
Publicat a:	Nutrition & diabetes, Vol. 12 Núm. 1 (december 2022) , p. 24, ISSN 2044-4052

DOI: 10.1038/s41387-022-00201-7
PMID: 35459205

13 p, 682.7 KB

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