Marker Arwen M, Noser Amy E, Knecht Nicole, Clements Mark A, Patton Susana R
1 Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA.
2 University of Kansas, Lawrence, KS, USA.
J Diabetes Sci Technol. 2019 Jan;13(1):68-74. doi: 10.1177/1932296818778608. Epub 2018 Jun 1.
Greater knowledge about nutrition and carbohydrate counting are associated with improved glycemic control and quality of life in youth with type 1 diabetes (T1D). However, limited assessments of nutrition and carbohydrate knowledge have been developed, and existing measures can be time-consuming, overly broad, or not conducive to routine clinical use. To fill this gap, we developed and examined the feasibility of administering the electronic Nutrition and Carbohydrate Counting Quiz (eNCQ).
Ninety-two caregivers and 70 youth with T1D (mean age 12.5 years; mean time since diagnosis 5 years; English speaking) completed the 19-item eNCQ via tablet during a routine clinical visit. Completion time and item completion rates were used to assess feasibility. Relationships between eNCQ scores and patient demographics, diabetes management, and health outcomes were examined.
Participants took 10 minutes, on average, to complete the eNCQ. Total and Carbohydrate subscale scores (youth report) were negatively correlated with youth hemoglobin A1c (total r = -.38, carbohydrate r = -.38, Ps < .05), indicating that greater nutrition knowledge related to better glycemic control. Nutrition knowledge scores were generally high, but knowledge was negatively related to time since diabetes diagnosis ( r = -.276, P < .05).
Findings support feasibility of the eNCQ to assess nutrition knowledge in routine clinical care. Following additional acceptability and validity testing, the eNCQ may identify families in need of further nutrition education. Nutrition assessment is particularly indicated for youth over one year since T1D diagnosis, as these families displayed lower nutrition knowledge and may need continuing education to maintain diabetes-specific nutrition knowledge over time.
对营养和碳水化合物计数有更多了解与改善1型糖尿病（T1D）青少年的血糖控制和生活质量相关。然而，针对营养和碳水化合物知识的评估方法有限，现有措施可能耗时、过于宽泛或不利于常规临床应用。为填补这一空白，我们开发并检验了电子营养与碳水化合物计数测验（eNCQ）的可行性。
92名护理人员和70名T1D青少年（平均年龄12.5岁；平均诊断后时间5年；说英语）在常规临床就诊期间通过平板电脑完成了19项的eNCQ。使用完成时间和项目完成率来评估可行性。研究了eNCQ分数与患者人口统计学、糖尿病管理和健康结果之间的关系。
参与者平均花费10分钟完成eNCQ。总分和碳水化合物分量表分数（青少年报告）与青少年糖化血红蛋白呈负相关（总分r = -0.38，碳水化合物r = -0.38，P < 0.05），表明更多的营养知识与更好的血糖控制相关。营养知识分数总体较高，但知识与糖尿病诊断后的时间呈负相关（r = -0.276，P < 0.05）。
研究结果支持eNCQ在常规临床护理中评估营养知识的可行性。经过进一步的可接受性和有效性测试后，eNCQ可能会识别出需要进一步营养教育的家庭。对于T1D诊断后超过一年的青少年，尤其需要进行营养评估，因为这些家庭的营养知识较低，可能需要持续教育以长期维持特定于糖尿病的营养知识。
