Emphasis on Carbohydrates May Negatively Influence Dietary Patterns in Youth With Type 1 Diabetes

OBJECTIVE — To assess perceptions of healthful eating and the influence of diabetes man-agement on dietary behaviors among youth with type 1 diabetes and parents. RESEARCH DESIGN AND METHODS — Youth with type 1 diabetes (n 35), ages 8–21 years, and parents participated in focus groups. Focus group recordings were transcribed and coded into themes. Clinical data were abstracted from the electronic medical record. RESULTS — Central topics were perceptions of healthful eating and the impact of diabetes management on diet. An emphasis on limiting postprandial glycemic excursions occasionally contradicted the traditional perception of healthful eating, which emphasized consumption of nutrient-dense whole foods in favor of prepackaged choices. Whereas fixed regimens required more rigid diets, basal-bolus regimens provided more opportunities for unhealthful eating. Most youth perceived “refined ” grains as more healthful grains. CONCLUSIONS — For youth with type 1 diabetes and parents, an emphasis on carbohy-drate quantity over quality may distort beliefs and behaviors regarding healthful eating. Diabetes Care 32:2174–2176, 2009 M edical nutrition therapy for youthwith type 1 diabetes is designed tomaintain normal growth and de