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Nutritional status, dietary intake, and nutrition-related interventions among older adults with type 1 diabetes: A systematic review and call for more evidence towards clinical guidelines

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posted on 2024-04-30, 15:15 authored by Angelica Cristello Sarteau, Gabriella Ercolino, Rashmi Muthukkumar, Angela Fruik, Elizabeth J. Mayer-Davis, Anna R. Kahkoska

There is an emerging population of older adults (≥65 years) living with type 1 diabetes. Optimizing health through nutrition during this life stage is challenged by multiple and ongoing changes in diabetes, co-morbidities, and lifestyle factors. There is a need to understand nutritional status, dietary intake, and nutrition-related interventions that may maximize well-being throughout the lifespan in type 1 diabetes, in addition to nutrition recommendations from clinical guidelines and consensus reports.

Three reviewers used Cochrane guidelines to screen original research (January 1993 – 2023) and guidelines (2012 – 2023) in two databases (MEDLINE and CENTRAL) to characterize nutrition evidence in this population.

We found limited original research explicitly focused on nutrition and diet in adults ≥65 years of age with type 1 diabetes (6 experimental studies, 5 observational studies) and meta-analyses/reviews (n=1 scoping review),since the majority of analyses combined individuals ≥65 years with those ≥18 years with diverse diabetes durations, and also combined individuals with type 1 and type 2 diabetes. Further, existing clinical guidelines (n=10) lacked detail and evidence to guide clinical practice and self-management behaviors in this population.

From a scientific perspective, little is known about nutrition and diet among older adults with type 1 diabetes, including baseline nutrition status, dietary intake and eating behaviors, and the impact of nutrition interventions on key clinical and patient-oriented outcomes. This likely reflects the population’s recent emergence and unique considerations. Addressing these gaps is foundational to developing evidence-based nutrition practices and guidelines for older adults living with type 1 diabetes.

Funding

Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number P30DK056350. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ARK is supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant K12TR004416. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. ARK also reports receiving research grants from the Diabetes Research Connection and the American Diabetes Association, and a prize from the National Academy of Medicine, outside the submitted work.

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