Demographic details, clinical features, and nutritional characteristics of young adults with Type 1 diabetes mellitus - A South Indian tertiary center experience

Abstract

Context:Type 1 diabetes mellitus (T1DM) accounts for 5–10% of all diagnosed diabetes and the highest incidence is found in India.Aims:The main objectives were to study the demographic, clinical, and nutritional characteristics of young adults with T1DM and its effect glycosylated hemoglobin levels.Subjects and Methods:This cross-sectional study was conducted among young adults with T1DM (18–45 years of age) in a tertiary hospital in South India. Data were obtained from updated medical records. The dietary data were assessed from food diaries and 24 h recall method. Anthropometry was determined.Results:The analysis revealed that socio-economic variables did not affect the glycosylated hemoglobin levels. The mean glycosylated hemoglobin value was 8.81 ± 2.38%. Nearly, half the patients were malnourished. The overall dietary intake was inadequate. The multivariate regression model, adjusted for confounding factors such as gender, age, and body mass index, revealed that only duration of diabetes and protein intake were significant predictors of glycosylated hemoglobin status (P < 0.005).Conclusion:Integrated care provided at subsidized cost has been pivotal in effective diabetes management. However, there is an urgent need to educate our patients on nutrition therapy. T1DM patients need specialized advice to ensure appropriately balanced nutrition that has a significant impact on their long-term glycemic control.

Medical nutrition therapy of pediatric type 1 diabetes mellitus in India: Unique aspects and challenges

“…Similar findings have been reported in north Indian patients with T2DM, where knowledge, attitude, and practices with respect to diabetes management were found to be unsatisfactory 58 . There is evidence that academic knowledge does not always translate into positive action 53 Lack of supervision: Communication with school authorities about providing a nurse or other responsible staff to supervise procedures/meals and having a responsible adult at home do the same (in an unobtrusive manner) can improve compliance. Widespread availability of junk food : Unhealthy packaged foods are freely available in Indian markets 59 .…”

“…There are various other challenges in ensuring adherence to MNT that should be anticipated and addressed in problem‐solving sessions. Economic barriers: A systematic review of the possible barriers affecting good diabetes management found that besides attitude, beliefs and knowledge, finance resources is an important factor 51 . A study from south India noted that over 50% of patients attending an integrated diabetes clinic were daily wage earners who had to travel long distances to seek medical care, incurring travel costs besides loss of income 52,53 . A study from north India revealed that the mean direct cost of diabetes management per patient per year was 18.6% of annual family income.…”

“…51 A study from south India noted that over 50% of patients attending an integrated diabetes clinic were daily wage earners who had to travel long distances to seek medical care, incurring travel costs besides loss of income. 52,53 A study from north India revealed that the mean direct cost of diabetes management per patient per year was 18.6% of annual family income. Patients from lower income bracket spend a larger proportion of the family income (32.6%) on diabetes care.…”

“…58 There is evidence that academic knowledge does not always translate into positive action. 53 • Lack of supervision: Communication with school authorities about providing a nurse or other responsible staff to supervise procedures/meals and having a responsible adult at home do the same (in an unobtrusive manner) can improve compliance.…”

Characteristics of carbohydrate counting practice associated with adequacy of glycated hemoglobin in adults with type 1 diabetes mellitus in Brazil

“…Furthermore, an association was found between having an increased HbA1c and having malnutrition according to BMI, which may be related to an imbalance in food consumption and, consequently, calories, due to fear of increased blood glucose, resulting in uncontrolled glycemic control, ketosis and other complications important for nutritional status ( 32 – 34 ). Another factor that can interfere with the nutritional status of patients with DM1 is diabulimia, a term that characterizes the omission of insulin doses in order to lose weight ( 35 , 36 ).…”