936-P: Nutrition Experiences among Caregivers of Youth with Type 1 Diabetes

Abstract

Many children with type 1 diabetes (T1D) do not meet nutritional guidelines. Little is known about how caregivers perceive the necessity of appointments with a dietitian (RD) or how satisfied they are with their nutrition care. To better understand caregiver nutrition experiences and perceptions, we surveyed 838 families of children <18 years old receiving T1D care at Boston Children’s Hospital (BCH). Of 184 (22%) responses, 159 with complete data were analyzed. Using multivariable logistic regression, we assessed factors associated with caregiver (1) perception of the necessity for annual nutrition visits; (2) satisfaction with nutrition care and (3) encouragement from a nurse or doctor to meet with an RD. Covariates included child’s age, diabetes duration, gender, race and ethnicity, and diabetes technology use. Age and diabetes duration were categorized as <13 and ≥ 13 years old and ≤ 3 and > 3 years, respectively. Among children in the analysis, 55% were ≥ 13 years old and 51% had T1D for ≤ 3 years. Over half (56.6%) of respondents considered it necessary to see a RD every year. Older age (aOR=2.06, 95% CI [1.01, 4.20]) and shorter disease duration (aOR=2.50, 95% CI [1.22, 5.12]) were associated with this perception. Less than half (47.8%) reported satisfaction with their nutrition care, with shorter disease duration associated with a higher likelihood of satisfaction (aOR=2.24, 95% CI [1.13, 4.42]). Only 61.4% of respondents reported encouragement from a nurse or doctor to meet with a RD. No demographic or clinical characteristics were associated with this finding. Our findings suggest that caregiver satisfaction with nutrition care and its perceived need for children with T1D may wane with longer disease duration. However, the perceived need for nutrition services is also higher in parents of teens. Future work should delineate strategies for engaging families in nutrition education that is more tailored to later stages of the T1D journey. In addition, there is a need for teen-focused T1D nutrition care curricula. Disclosure E. N. Gordon: None. B. S. Dykeman: None. K. Greco: None. E. Rhodes: Other Relationship; Self; AstraZeneca. K. Garvey: None.