280-OR: Medical Nutrition Therapy and Glycemic Control in Youth-Onset Diabetes: SEARCH for Diabetes in Youth Study

Abstract

Medical nutrition therapy (MNT) is integral to diabetes (DM) management, but little is known about MNT use in youth and young adults. The SEARCH for Diabetes in Youth study assessed MNT use among 1476 participants with type 1 DM (T1D) and 245 with type 2 DM (T2D) who had up to 3 research visits over 5.2 years (range 1.7-11.5). Participants reported often, sometimes, or never using each of 10 MNT strategies, which we categorized with 5 mutually exclusive groups: often using across visits; start using at later visits; sometimes using across visits; stop using at later visits; or never using at every visit. We used general linear models to examine A1c levels at the most recent visit (mean 11.0 [range 6.3-17.0] years after DM diagnosis) for each MNT strategy, adjusting for sociodemographic and DM-related variables. Most participants with T1D reported often counting carbs (n=1080, 75%), while half (n=107, 47%) of those with T2D reported often limiting sweets. Table presents significant associations of A1c levels with MNT use by DM type. In T1D, mean A1c differed significantly across MNT use of 7 strategies, but only for 2 strategies in T2DM. For both T1D and T2D, A1c did not differ by use of dietary exchanges, drinking more milk, or eating more fruits/vegetables. Our data suggest that often using most MNT strategies is related to relatively better glycemic control in T1D, but this applies to fewer MNT strategies for T2DM. Disclosure K.A. Sauder: None. J.M. Stafford: None. N.S. The: None. E.J. Mayer-Davis: None. J. Thomas: None. J.M. Lawrence: None. G. Kim: None. K.R. Siegel: None. E.T. Jensen: None. A.S. Shah: None. R. Dagostino: Consultant; Self; Amgen, AstraZeneca, Celgene, Daiichi Sankyo. D. Dabelea: None. Funding National Institutes of Health