O-49: Cooking up better control: innovative Community-Based nutritional education program improves HbA1c in overweight and obese teens with type 1 diabetes (T1D)
C Corey, A Nevin, A Goncher, S Nouraie, U Muzumdar, I LibmanAbstract
Introduction
Most youth with T1D do not meet their glycemic targets, and nearly a third are overweight or obese. Families often report having significant difficulty with the healthy eating aspects of diabetes care.
Objectives
This pilot study evaluated participation and effectiveness of a structured, virtual lifestyle and nutrition program in overweight and obese adolescents with T1D as an adjunct to standard diabetes care. The central hypothesis was that participation led to improved glycemic control (HbA1c) and to maintenance or reduction in body mass index (BMI) compared with baseline measures.
Methods
Overweight youth with T1D (n=46) were recruited from a pediatric diabetes academic center. Participants engaged in up to 6 virtual cooking classes led by a chef, diabetes care and education specialist (DCES), and dietitian over a period of 3 months using home-delivered ingredients in partnership with community organizations.
Results
Participants were 59% female, 72% white, mean (SD) age 15.5±1.8y, median T1D duration 6.3y (IQR: 3.3-9.9), median BMI 27.6kg/m2(IQR: 25.4-31.9), 89% with CGM use, 61% with insulin pumps, mean baseline HbA1c of 8.3±1.8%. Almost 90% of those recruited attended at least one class, with 66% attending at least 2 and 57% at least 3. HbA1c significantly improved (-0.3%, p=0.044) from baseline to follow-up visit. After adjusting for sex, T1D duration, and age, attending 2 (-1.4%, p=0.019) or 3 (-0.9%, p=0.015) classes remained significantly associated with improvement in HbA1c. There was no change in BMI (p=0.58).
Conclusions
This novel, virtual, educational cooking program for overweight youth with T1D engaged participants and resulted in improved glycemic control with no increase in BMI. These findings suggest a beneficial effect of an interactive program that supports lifestyle and nutrition education and warrant further investigation to determine the optimal programming to support the nutritional needs of overweight youth with T1D.