Use of snacks in insulin-treated people with diabetes mellitus and association with HbA1c , weight and quality of life: a cross sectional study.

Abstract

Insulin therapies with prandial injections offer the possibility to skip snacks or omit meals. It is unclear how many people with insulin-treated diabetes mellitus eat snacks and whether they snack for their own comfort or only on the recommendation of healthcare professionals. In 2004, 163 consecutive people with insulin-treated diabetes seen in a university outpatient department were interviewed regarding their diet and degree of satisfaction with their meals. Fifty-five had Type1 diabetes [age 47years; diabetes duration 18years; BMI 27kg/m(2) ; HbA1c 62mmol/mol (7.8%)], 53 had Type2 diabetes with biphasic insulin therapy [age 68years; diabetes duration 17years; BMI 31kg/m(2) ; HbA1c 60mmol/mol (7.6%)] and 55 had Type2 diabetes with prandial insulin therapy [age 60years; diabetes duration 16years; BMI 33kg/m(2) ; HbA1c 59mmol/mol (7.6%)]. Eighty percent of those with Type1 diabetes ate snacks, together with 77% of the Type2 diabetes/biphasic group and 62% of the Type2 diabetes/prandial group. Most participants (91% Type1 diabetes, 88% Type2 diabetes/biphasic group, 82% Type2 diabetes/prandial group) liked to have snacks. The time at which they ate snacks was the same for both diabetes types. There were no differences between participants with Type1 diabetes who snacked and those who did not in terms of age (P=0.350), BMI (P=0.368), HbA1c (P=0.257) and time since diagnosis (P=0.846). Participants with Type2 diabetes who ate snacks were older than those who did not (biphasic: P=0.006; prandial: P=0.008). There were no differences in terms of BMI (biphasic: P=0.731; prandial: P=0.393), HbA1c (biphasic: P=0.747; prandial: P=0.616) and time since diagnosis (biphasic: P=0.06; prandial: P=0.620). Most people with insulin-treated diabetes eat snacks voluntarily and not because of physicians' instructions. There were no correlations between the use of snacks and HbA1c , BMI and time since diagnosis, except that the participants with Type2 diabetes who ate snacks were older.