Clinical Child Psychology Program, University of Kansas.
Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center.
J Pediatr Psychol. 2020 Aug 1;45(7):749-758. doi: 10.1093/jpepsy/jsaa046.
There is limited information regarding the potential effect macronutrients have on postprandial glycemic variability in young children with type 1 diabetes (T1D). To date, studies examining nutrition and glycemic outcomes either assess these factors at a single timepoint, or aggregate large datasets for group level analyses. This study examined how inter- and intraindividual fluctuations in carbohydrate, fat, and protein intake impact glycemic variability in the postprandial period for young children with T1D.
Thirty-nine young children, aged 2-6 years, wore a continuous glucose monitor for 72 hr, while their parents completed detailed diet records of all food intake. The analyses tested three multilevel models to examine intra- and interindividual differences between food intake and postprandial glycemic variability.
The results suggest carbohydrate intake, relates to greater postprandial glycemic variability. In contrast, the results reveal the inverse effect for protein, suggesting a tendency for young children who ate more protein at some meals to have lower postprandial glycemic variability, with the exception of lunch. There was no effect for fat on postprandial glycemic variability.
These results suggest protein consumption may be an important consideration when aiming for optimal glycemic levels for some meals. When counseling parents of young children with T1D on common behaviors underlying glycemic excursion, pediatric psychologists may consider discussing the nutritional make up of children's meals. Further, the results demonstrate retaining longitudinal data at the person level, versus aggregating individual data for group level analyses, may offer new information regarding macronutrient intake and glycemic outcomes.
关于宏量营养素对 1 型糖尿病（T1D）儿童餐后血糖变异性的潜在影响，相关信息有限。迄今为止，研究营养和血糖结果的研究要么在单个时间点评估这些因素，要么汇总大型数据集进行组水平分析。本研究旨在探讨 T1D 儿童碳水化合物、脂肪和蛋白质摄入的个体内和个体间波动如何影响餐后血糖变异性。
39 名年龄在 2-6 岁的儿童佩戴连续血糖监测仪 72 小时，同时其父母详细记录所有食物摄入量的饮食记录。该分析测试了三个多层次模型，以检查食物摄入和餐后血糖变异性之间的个体内和个体间差异。
结果表明，碳水化合物摄入与餐后血糖变异性增加有关。相比之下，蛋白质的结果呈现出相反的效果，这表明在某些餐次中摄入更多蛋白质的儿童餐后血糖变异性较低，但午餐除外。脂肪对餐后血糖变异性没有影响。
这些结果表明，在某些餐次中，蛋白质的摄入可能是达到最佳血糖水平的重要考虑因素。当小儿糖尿病患儿的父母就血糖波动的常见行为进行咨询时，儿科心理学家可能会考虑讨论儿童膳食的营养构成。此外，结果表明，保留个体水平的纵向数据，而不是汇总个体数据进行组水平分析，可能会提供有关宏量营养素摄入和血糖结果的新信息。
