Patient Characteristics Associated With Annual Nutrition Visits in Children With Type 1 Diabetes

Area of Science:

• Pediatric Endocrinology
• Nutrition Science
• Diabetes Management

Background:

• Diabetes organizations recommend annual nutrition education by a registered dietitian (RD) for children with type 1 diabetes (T1D).
• Understanding RD engagement patterns and associated factors is crucial for optimizing T1D care in pediatric populations.

Purpose of the Study:

• To examine temporal trends in annual RD follow-up rates among children with T1D.
• To identify patient characteristics linked to RD engagement in this demographic.

Main Methods:

• Analysis of 6034 diabetes medical visits from 1982 pediatric patients with T1D (≥1 year duration) over 5 years (2018-2022).
• Generalized estimating equations used to assess changes in RD visit completion rates and identify associated patient factors (sociodemographic, diabetes care, clinical).
• Models were stratified by race and ethnicity.

Main Results:

• The overall annual RD follow-up rate was 20.8%, with a decline observed in 2021 compared to 2018.
• Increased age and longer diabetes duration were associated with a reduced likelihood of RD follow-up (odds reduction of 3% per year of age and 15% per year of diabetes duration).
• RD follow-up correlated with lower subsequent hemoglobin A1c levels, with the most significant improvements noted in Hispanic patients.

Conclusions:

• Annual RD visit frequency among children with T1D remains suboptimal.
• Findings highlight the need for targeted interventions to enhance RD engagement.
• RD follow-up appears to be associated with improved glycemic outcomes in pediatric T1D.