Emphasis on Carbohydrates May Negatively Influence Dietary Patterns in Youth with Type 1 Diabetes

  1. Sanjeev N. Mehta, MD, MPH1,
  2. Denise L. Haynie, PhD, MPH2,
  3. Laurie A. Higgins, MS, RD, LDN, CDE1,
  4. Natalie N. Bucey, MA1,
  5. Alisha J. Rovner, PhD2,
  6. Lisa K. Volkening, MA1,
  7. Tonja R. Nansel, PhD2 and
  8. Lori M.B. Laffel, MD, MPH (lori.laffel{at}
  1. 1Joslin Diabetes Center - Section of Genetics and Epidemiology, 1 Joslin Place , Boston, Massachusetts 02215, United States
  2. 2Eunice Kennedy Shriver National Institute of Child Healt & Human Development - Prevention Research Branch, 6100 Executive Blvd. , Bethesda, Maryland 20892-7510, United States


    Objective— To assess perceptions of healthful eating and the impact of diabetes management on dietary behaviors among youth with type 1 diabetes (T1D) and their parents.

    Research Design And Methods— Youth with T1D (n=35), ages 8-20 years, and parents participated in focus groups. Focus group recordings were transcribed and coded into themes. Clinical data were abstracted from the electronic medical record.

    Results— Central topics were perceptions of healthful eating and the impact of diabetes management on diet. An emphasis on limiting postprandial glycemic excursions occasionally contradicted the traditional perception of healthful eating, which emphasized consumption of nutrient-dense, whole foods, in favor of pre-packaged choices. While fixed regimens required more rigid diets, basal-bolus regimens provided more opportunities for unhealthful eating. Most youth perceived “refined” grains as more healthful grains.

    Conclusions— For youth with T1D and parents, an emphasis on carbohydrate quantity over quality may distort beliefs and behaviors regarding healthful eating.


      • Received July 16, 2009.
      • Accepted September 2, 2009.