Special diet in type 1 diabetes: do gender and BMI-SDS differ?

ABSTRACT Background Diet modification has the potential to influence glycemic control and diabetes outcome in patients with type 1 diabetes (T1D). This cross-sectional study aimed to assess types of diets being reported by patients with T1D and documented in the Diabetes Patients Follow-Up Registry (DPV). Methods The DPV registry was screened for additional free text entries containing information about certain diets and/or physician-based diagnoses requiring special diets e. g. celiac disease. Descriptive analysis and unadjusted comparisons between patients with T1D following at least one special diet and controls (T1D without diet) were performed. Results Overall, 113,894 patients with T1D of all ages were included. In 2.3% (n = 2,595; median age 11.3 yrs [Q1; Q3: 7.0; 15.2]), at least one kind of diet was documented. These patients were significantly younger at diabetes onset than controls (median age 7.5 yrs [Q1; Q3: 3.9; 11.4] vs. 11.1 yrs [6.6; 16.7]; p < 0.001) and showed a significantly lower BMI-SDS (median [Q1; Q3]: 0.220 [−0.427;0.812] vs. 0.450 [−0.211;1.088]). Diet was more often reported in females (55.7% vs. 44.3%, p < 0.001). The three most common diets were gluten-free diet due to celiac disease, low-protein diet, and lactose-restricted diet due to lactose intolerance. A combination of two diagnoses in one patient (n = 44, 1.7% of the entire diet group) was predominantly intolerance to both fructose and lactose. Among all diet subgroups the highest BMI-SDS was found in the group diets for weight loss. Conclusions This study revealed a wide range of eating habits in patients with T1D. A special diet was more frequently documented in females. The main reason for adhering to a diet was a concomitant disease. As any diet modification could impact glycemic control, health care providers should be encouraged to regularly ask their patients about their eating habits and provide training and support by specialized dietitians.