Special diet in type 1 diabetes: do gender and BMI-SDS differ?

Background: Diet modification has the potential to influence glycemic control

and diabetes outcome in patients with type 1 diabetes (T1D). This cross-sectional

study aimed to assess types of diets being reported by patients with T1D

and documented in the Diabetes Patients Follow-Up Registry (DPV).

Methods: The DPV registry was screened for additional free text entries containing

information about certain diets and/or physician-based diagnoses

requiring special diets e. g. celiac disease. Descriptive analysis and unadjusted

comparisons between patients with T1D following at least one special diet and

controls (T1D without diet) were performed.

Results: Overall, 113,894 patients with T1D of all ages were included. In 2.3%

(n = 2,595; median age 11.3 yrs [Q1; Q3: 7.0; 15.2]), at least one kind of diet was

documented. These patients were significantly younger at diabetes onset than

controls (median age 7.5 yrs [Q1; Q3: 3.9; 11.4] vs. 11.1 yrs [6.6; 16.7]; p < 0.001)

and showed a significantly lower BMI-SDS (median [Q1; Q3]: 0.220 [−0.427;0.812]

vs. 0.450 [−0.211;1.088]). Diet was more often reported in females (55.7% vs.

44.3%, p < 0.001). The three most common diets were gluten-free diet due to

celiac disease, low-protein diet, and lactose-restricted diet due to lactose intolerance. A combination of two diagnoses in one patient (n = 44, 1.7% of the

entire diet group) was predominantly intolerance to both fructose and lactose.

Among all diet subgroups the highest BMI-SDS was found in the group diets for

weight loss.

Conclusions: This study revealed a wide range of eating habits in patients with

T1D. A special diet was more frequently documented in females. The main

reason for adhering to a diet was a concomitant disease. As any diet modification

could impact glycemic control, health care providers should be encouraged

to regularly ask their patients about their eating habits and provide

training and support by specialized dietitians.