Division of Child Behavioral Health, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital and The University of Michigan, Ann Arbor, MI 48109-5318, USA.
Pediatr Diabetes. 2009 Nov;10(7):455-60. doi: 10.1111/j.1399-5448.2009.00506.x. Epub 2009 Mar 11.
Previous research demonstrated high rates of perceived mealtime behavior problems in families of young children with type 1 diabetes who were managed with conventional therapy. Because of new insulin regimens that offer greater flexibility, reexamination of mealtime behaviors is required. We assessed parent-reported mealtime behaviors in a sample of young children using an insulin pump. An additional aim was to evaluate the associations of two measures of parental feeding behavior with children's glycemic control.
Primary caregivers of 31 young children (mean age = 5.0 +/- 1.3 yr) completed the Child Feeding Questionnaire (CFQ) and the Behavioral Pediatric Feeding Assessment Scale (BPFAS). Hemoglobin A1c (HbA1c) was used as a surrogate marker for children's glycemic control.
Children had a mean HbA1c of 7.8 +/- 0.64%. Mean CFQ - Restriction and Pressure to Eat scores were 3.1 +/- 0.94 and 2.0 +/- 0.88, respectively (range = 1-5). Mean BPFAS - Parent and Child scores were 16.0 +/- 4.3 (range = 10-50) and 44.9 +/- 9.3 (range = 25-125), respectively. Positive correlations were found between children's HbA1c levels and caregivers' reporting of frequency of child mealtime behavior problems.
Caregivers of young children on pump therapy report relatively low rates of mealtime behavior problems. However, correlations with children's HbA1c suggest that parent-child mealtime behaviors continue to relate to children's health outcomes. Research is needed to determine if changing mealtime interactions can improve children's glycemic control; items from the BPFAS and CFQ can offer targets to guide interventions.
先前的研究表明，在接受传统治疗的 1 型糖尿病幼儿家庭中，父母普遍认为患儿在用餐时存在行为问题。由于新的胰岛素方案提供了更大的灵活性，因此需要重新检查患儿的用餐行为。我们使用胰岛素泵评估了一组幼儿的父母报告的用餐行为。另一个目的是评估父母喂养行为的两个指标与儿童血糖控制之间的关联。
31 名幼儿的主要照顾者（平均年龄= 5.0 +/- 1.3 岁）完成了儿童喂养问卷（CFQ）和行为儿科喂养评估量表（BPFAS）。血红蛋白 A1c（HbA1c）被用作儿童血糖控制的替代标志物。
儿童的平均 HbA1c 为 7.8 +/- 0.64%。平均 CFQ - 限制和强迫进食得分分别为 3.1 +/- 0.94 和 2.0 +/- 0.88（范围为 1-5）。平均 BPFAS - 父母和儿童得分分别为 16.0 +/- 4.3（范围为 10-50）和 44.9 +/- 9.3（范围为 25-125）。儿童的 HbA1c 水平与照顾者报告的儿童用餐行为问题频率之间存在正相关关系。
使用胰岛素泵治疗的幼儿的照顾者报告的用餐行为问题发生率相对较低。然而，与儿童 HbA1c 的相关性表明，亲子用餐行为仍然与儿童的健康结果相关。需要研究是否改变用餐互动可以改善儿童的血糖控制；BPFAS 和 CFQ 的项目可以提供指导干预的目标。
