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, 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 Puente, Dídac (Institut d'Investigació Biomèdica Sant Pau)

Fecha:	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.
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).
Derechos:	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.
Lengua:	Anglès
Documento:	Article de revisió ; recerca ; Versió publicada
Materia:	Adolescent ; Diabetes Mellitus, Type 1 ; Diet ; Feeding Behavior ; Humans ; Lipids ; Nutrition Therapy
Publicado en:	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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