This study aimed to assess the association between caregiver's level of type 1 diabetes (T1D) nutrition knowledge with children's dietary diversity score (DDS), mean intake of macronutrients, nutrient adequacy ratios (NARs) and mean adequacy ratio (MAR). Research Design and Methods: A cross-sectional analytical study design was used. The study was conducted at 6 diabetes clinics in Uganda among 59 caregivers and 61 children. T1D nutrition knowledge survey (NKS) was used to assess the caregiver's nutrition knowledge, and the 24-hour dietary recall and dietary diversity score (DDS) questionnaires were used to collect data on the child's dietary intake. Results: Majority (93.2%) of the caregivers had low T1D nutrition knowledge. Carbohydrate counting was the least performed nutrition knowledge domain. The children's mean DDS, calorie intake and MAR were 5.7 ± 1.6, 666.7 ± 639.8 kcal and 0.7 ± 0.3, respectively. The mean NARs of carbohydrate, protein, and fat were 0.9 ± 0.3, 0.9 ± 0.4, 0.5 ± 0.5, respectively. There was a significant association between DDS with NARs of carbohydrate, protein, fat, vitamins A, B2, B3, B5, B12, folic acid, zinc and MAR. No formal education was significantly associated with a lower mean NKS score among caregivers (p = 0.039). Caregivers' T1D nutrition knowledge, age and family size explained 14% of variation in the child's dietary diversity (p = 0.041). Conclusion: Despite poor nutrition knowledge among caregivers especially on carbohydrate counting, dietary diversity among children with T1D remained favorable. Excess carbohydrate intake was observed with inadequate intake of proteins, fats and micronutrients (vitamin A, B vitamins and calcium). Caregivers with low education were more likely to register poor nutrition knowledge; therefore, there is need to develop and tailor nutrition education programmes to enhance comprehensive learning among caregivers for improved outcomes.
Introduction: Inadequate dietary management practices among children with type 1 diabetes mellitus (T1DM) often result in preventable complications, disability, and premature deaths, and yet strict glycaemic control can help reduce the long-term complications. Furthermore, parental caregiving has also been shown to have an impact on glycaemic control and yet often a gap exists between recommended care and provided care, resulting in failure of children with T1DM meeting their treatment targets. In Uganda, no published study has been conducted to find out if nutrition education has an effect on glycaemic control and caregivers level of knowledge on general and diabetes-specific nutrition for children with T1DM. Methods: The study will be a cluster randomised controlled trial with 10 health facilities randomised to control or intervention at a ratio of 1:1. A total of 100 caregiver-child pairs will be recruited. The participants in the control group will continue to receive routine medical care, while those in the intervention group will receive routine medical care and a nutrition education package. The primary outcome is glycated hemoglobin (HbA1c) values. Secondary outcomes will be caregivers level of knowledge on general and diabetes-specific nutrition knowledge, childrens dietary diversity score and childrens mean intake of energy, protein, and fat. Discussion: The findings of this study will be used in improving nutrition education in T1DM among children attending diabetes clinics in Uganda. Trial registration number: The trial is registered with The Pan African Clinical Trials Registry (PACTR201902548129842).
This study will aim to evaluate whether the provision of a structured nutrition education course to caregivers of children and adolescents with type 1 diabetes mellitus (T1DM) will help improve their children's glycemic control, dietary intake, and diversity. Research Design and Methods: The study will be a cluster randomized controlled trial conducted at 10 health facilities with established T1DM clinics in Uganda. The facilities will include:
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