1型糖尿病患儿饮食管理的研究进展
Research Progress on Dietary Management for Children with Type 1 Diabetes Mellitus
DOI: 10.12677/acm.2025.1541049, PDF,   
作者: 梁艳梅, 罗雁红*：重庆医科大学附属儿童医院内分泌科，重庆；国家儿童健康与疾病临床医学研究中心，重庆；儿童发育疾病研究教育部重点实验室，重庆；儿童发育重大疾病国家国际科技合作基地，重庆；儿童代谢与炎症性疾病重庆市重点实验室，重庆
关键词: 1型糖尿病；饮食管理；研究进展；Type 1 Diabetes； Dietary Management； Research Progress
摘要: 儿童青少年1型糖尿病是一种胰岛素绝对缺乏的代谢障碍性疾病，需要终身综合管理。饮食管理是1型糖尿病患儿综合管理的重要手段之一。本文对1型糖尿病患儿的饮食管理现状管理进行综述，阐述1型糖尿病患儿饮食管理的现状、可能的影响因素和饮食管理的进展，为1型糖尿病患儿的饮食管理提供参考依据，以达到帮助患者更好地管理血糖、提高生活质量、降低远期并发症的目的。
Abstract: Type 1 diabetes in children and adolescents is a metabolic disorder characterized by absolute insulin deficiency, requiring lifelong comprehensive management. Dietary management is one of the important means of comprehensive management for children with type 1 diabetes. This article reviews the current status of dietary management for children with type 1 diabetes, elaborates on the current situation, possible influencing factors, and progress in dietary management for these children, providing a reference basis for dietary management of children with type 1 diabetes, with the aim of helping patients better manage their blood sugar, improve their quality of life, and reduce long-term complications.
文章引用：梁艳梅, 罗雁红. 1型糖尿病患儿饮食管理的研究进展[J]. 临床医学进展, 2025, 15(4): 1217-1223. https://doi.org/10.12677/acm.2025.1541049

参考文献

[1] 中华医学会儿科学分会内分泌遗传代谢学组, 中华儿科杂志编辑委员会. 中国儿童1型糖尿病标准化诊断与治疗专家共识(2020版) [J]. 中华儿科杂志, 2020, 58(6): 447-454.
[2] Tuomilehto, J., Ogle, G.D., Lund-Blix, N.A. and Stene, L.C. (2020) Update on Worldwide Trends in Occurrence of Childhood Type 1 Diabetes in 2020. Pediatric Endocrinology Reviews: PER, 17, 198-209.
[3] Rankin, D., Harden, J., Barnard, K., Bath, L., Noyes, K., Stephen, J., et al. (2018) Barriers and Facilitators to Taking on Diabetes Self-Management Tasks in Pre-Adolescent Children with Type 1 Diabetes: A Qualitative Study. BMC Endocrine Disorders, 18, Article No. 71. [Google Scholar] [CrossRef] [PubMed]
[4] Li, G., Huang, K., Dong, G., Zhang, J., Gong, C., Luo, F., et al. (2022) Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers. Frontiers in Pediatrics, 10, Article ID: 888370. [Google Scholar] [CrossRef] [PubMed]
[5] Ogle, G.D., von Oettingen, J.E., Middlehurst, A.C., Hanas, R. and Orchard, T.J. (2018) Levels of Type 1 Diabetes Care in Children and Adolescents for Countries at Varying Resource Levels. Pediatric Diabetes, 20, 93-98. [Google Scholar] [CrossRef] [PubMed]
[6] 郑敏燕, 许玉莲, 王育红, 等. 评价小儿糖尿病患者采用饮食疗法对其预后的影响[J]. 糖尿病新世界, 2023, 26(16): 43-45+49.
[7] Annan, S.F., Higgins, L.A., Jelleryd, E., Hannon, T., Rose, S., Salis, S., et al. (2022) ISPAD Clinical Practice Consensus Guidelines 2022: Nutritional Management in Children and Adolescents with Diabetes. Pediatric Diabetes, 23, 1297-1321. [Google Scholar] [CrossRef] [PubMed]
[8] Sacks, F.M., Lichtenstein, A.H., Wu Jason, H.Y., Appel, L.J., et al. (2017) Dietary Fats and Cardiovascular Disease: A Presidential Advisory from the American Heart Association. Circulation, 136, e1-e23.
[9] Nip, A.S.Y., Reboussin, B.A., Dabelea, D., Bellatorre, A., Mayer-Davis, E.J., Kahkoska, A.R., et al. (2019) Disordered Eating Behaviors in Youth and Young Adults with Type 1 or Type 2 Diabetes Receiving Insulin Therapy: The SEARCH for Diabetes in Youth Study. Diabetes Care, 42, 859-866. [Google Scholar] [CrossRef] [PubMed]
[10] Cezar, P., Gonçalves, R.R., Schainberg, A., Comim, F.V. and Oliveira, S.C. (2022) Higher Score of Diabetes Eating Problem Survey-Revised (DEPS-R) Is Associated with Poor Glycemic Control among Brazilian Patients with Type 1 Diabetes (T1DM): A Brief Report. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 16, Article ID: 102570. [Google Scholar] [CrossRef] [PubMed]
[11] 魏真真. 1型糖尿病患儿血糖控制的影响因素分析[J]. 妇儿健康导刊, 2023, 2(22): 86-88+115.
[12] Mackey, E.R., O’Brecht, L., Holmes, C.S., Jacobs, M. and Streisand, R. (2018) Teens with Type 1 Diabetes: How Does Their Nutrition Measure up? Journal of Diabetes Research, 2018, Article ID: 5094569. [Google Scholar] [CrossRef] [PubMed]
[13] Mayer-Davis, E.J., Nichols, M., Liese, A.D., Bell, R.A., Dabelea, D.M., Johansen, J.M., et al. (2006) Dietary Intake among Youth with Diabetes: The SEARCH for Diabetes in Youth Study. Journal of the American Dietetic Association, 106, 689-697. [Google Scholar] [CrossRef] [PubMed]
[14] Gilbertson, H.R., Reed, K., Clark, S., Francis, K.L. and Cameron, F.J. (2018) An Audit of the Dietary Intake of Australian Children with Type 1 Diabetes. Nutrition & Diabetes, 8, Article No. 10. [Google Scholar] [CrossRef] [PubMed]
[15] Seckold, R., Howley, P., King, B.R., Bell, K., Smith, A. and Smart, C.E. (2019) Dietary Intake and Eating Patterns of Young Children with Type 1 Diabetes Achieving Glycemic Targets. BMJ Open Diabetes Research & Care, 7, e000663. [Google Scholar] [CrossRef] [PubMed]
[16] Thongpaeng, S., Sorncharoen, P., Preechasuk, L. and Santiprabhob, J. (2022) Dietary Intake and Physical Activity of Thai Children and Adolescents with Type 1 Diabetes Mellitus. Nutrients, 14, Article No. 5169. [Google Scholar] [CrossRef] [PubMed]
[17] Dłużniak-Gołaska, K., Panczyk, M., Szostak-Węgierek, D., Szypowska, A. and Sińska, B. (2019) Analysis of the Diet Quality and Dietary Habits of Children and Adolescents with Type 1 Diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 161-170. [Google Scholar] [CrossRef] [PubMed]
[18] Sundberg, F., Augustsson, M., Forsander, G., Cederholm, U. and Axelsen, M. (2014) Children under the Age of Seven with Diabetes Are Increasing Their Cardiovascular Risk by Their Food Choices. Acta Paediatrica, 103, 404-410. [Google Scholar] [CrossRef] [PubMed]
[19] Mehta, S.N., Volkening, L.K., Quinn, N. and Laffel, L.M.B. (2014) Intensively Managed Young Children with Type 1 Diabetes Consume High-Fat, Low-Fiber Diets Similar to Age-Matched Controls. Nutrition Research, 34, 428-435. [Google Scholar] [CrossRef] [PubMed]
[20] 周美景, 王洪, 于健, 等. 青少年1型糖尿病患者饮食行为紊乱的调查研究[J]. 中华护理杂志, 2023, 58(8): 956-962.
[21] Cecilia‐Costa, R., Volkening, L.K. and Laffel, L.M. (2019) Factors Associated with Disordered Eating Behaviours in Adolescents with Type 1 Diabetes. Diabetic Medicine, 36, 1020-1027. [Google Scholar] [CrossRef] [PubMed]
[22] Doyle, E.A., Quinn, S.M., Ambrosino, J.M., Weyman, K., Tamborlane, W.V. and Jastreboff, A.M. (2017) Disordered Eating Behaviors in Emerging Adults with Type 1 Diabetes: A Common Problem for both Men and Women. Journal of Pediatric Health Care, 31, 327-333. [Google Scholar] [CrossRef] [PubMed]
[23] Lv, W., Zhong, Q., Guo, J., Luo, J., Dixon, J. and Whittemore, R. (2021) Instrument Context Relevance Evaluation, Translation, and Psychometric Testing of the Diabetes Eating Problem Survey-Revised (DEPS-R) among People with Type 1 Diabetes in China. International Journal of Environmental Research and Public Health, 18, Article No. 3450. [Google Scholar] [CrossRef] [PubMed]
[24] Nilsson, F., Madsen, J.O.B., Jensen, A.K., Olsen, B.S. and Johannesen, J. (2020) High Prevalence of Disordered Eating Behavior in Danish Children and Adolescents with Type 1 Diabetes. Pediatric Diabetes, 21, 1043-1049. [Google Scholar] [CrossRef] [PubMed]
[25] Olmsted, M.P., Colton, P.A., Daneman, D., Rydall, A.C. and Rodin, G.M. (2008) Prediction of the Onset of Disturbed Eating Behavior in Adolescent Girls with Type 1 Diabetes. Diabetes Care, 31, 1978-1982. [Google Scholar] [CrossRef] [PubMed]
[26] Eljamal, S., Elfane, H., Chamlal, H., et al. (2022). Assessment of Diet Quality in Children and Adolescents with Type 1 Diabetes. Roczniki Panstwowego Zakladu Higieny, 73, 413-422.
[27] 杨飞凤, 王喆, 李志强, 等. 连续血糖监测技术研究进展[J]. 中国医疗设备, 2024, 39(10): 159-164.
[28] 李启富. 动态血糖监测的临床评价及应用[J]. 中国糖尿病杂志, 2024, 32(8): 638-640.
[29] 刘燕凤, 陈婷丽, 郑忠实. 胰岛素泵长期持续皮下胰岛素输注治疗儿童1型糖尿病效果的影响因素[J]. 中国当代医药, 2024, 31(29): 75-78.
[30] 安凯, 邱浩, 雷健波. 国内糖尿病管理App用户满意度及影响因素研究[J]. 医学信息学杂志, 2025, 46(1): 44-50.
[31] 赵璇, 张悦悦, 张璟博, 等. 移动医疗应用程序在德国糖尿病管理中的应用及其启示[J]. 医学与哲学, 2024, 45(15): 64-68.
[32] Cameron, F.J., Skinner, T.C., De Beaufort, C.E., Hoey, H., Swift, P.G.F., Aanstoot, H., et al. (2008) Are Family Factors Universally Related to Metabolic Outcomes in Adolescents with Type 1 Diabetes? Diabetic Medicine, 25, 463-468. [Google Scholar] [CrossRef] [PubMed]
[33] Snyder, L.L., Stafford, J.M., Dabelea, D., Divers, J., Imperatore, G., Law, J., et al. (2019) Socio‐Economic, Demographic, and Clinical Correlates of Poor Glycaemic Control within Insulin Regimens among Children with Type 1 Diabetes: The Search for Diabetes in Youth Study. Diabetic Medicine, 36, 1028-1036. [Google Scholar] [CrossRef] [PubMed]
[34] 吴星星, 韩新容. 早期健康教育及营养干预对1型糖尿病患儿自我管理能力及家属知识掌握情况的影响分析[J]. 糖尿病新世界, 2022, 25(24): 160-163.
[35] 邱翠竹, 王明珠, 罗少莊, 等. 青少年1型糖尿病患者自我管理能力现状及影响因素的调查研究[J]. 中国医药科学, 2018, 8(6): 10-13+30.
[36] 赵倩, 彭慧芳, 尚丽景, 等. 1型糖尿病膳食治疗的研究进展[J]. 医学综述, 2021, 27(22): 4519-4524.
[37] Mańkiewicz-Żurawska, I. and Jarosz-Chobot, P. (2019) Nutrition of Children and Adolescents with Type 1 Diabetes in the Recommendations of the Mediterranean Diet. Pediatric Endocrinology, Diabetes, and Metabolism, 25, 74-80.
[38] Levran, N., Levek, N., Sher, B., et al. (2023) The Mediterranean Diet for Adolescents with Type 1 Diabetes: A Prospective Interventional Study. Nutrients, 15, Article No. 4577.
[39] Zhong, V.W., Lamichhane, A.P., Crandell, J.L., Couch, S.C., Liese, A.D., The, N.S., et al. (2016) Association of Adherence to a Mediterranean Diet with Glycemic Control and Cardiovascular Risk Factors in Youth with Type I Diabetes: The SEARCH Nutrition Ancillary Study. European Journal of Clinical Nutrition, 70, 802-807. [Google Scholar] [CrossRef] [PubMed]
[40] Quarta, A., Guarino, M., Tripodi, R., Giannini, C., Chiarelli, F. and Blasetti, A. (2023) Diet and Glycemic Index in Children with Type 1 Diabetes. Nutrients, 15, Article No. 3507. [Google Scholar] [CrossRef] [PubMed]
[41] Neyman, A., Hannon, T.S., Corkins, M.R., Blanco, C.L., Fuchs, G.J., Goday, P.S., et al. (2023) Low-Carbohydrate Diets in Children and Adolescents with or at Risk for Diabetes. Pediatrics, 152, e2023063755. [Google Scholar] [CrossRef] [PubMed]
[42] 夏静. 青少年1型糖尿病患者自我管理教育方案的构建及应用[D]: [硕士学位论文]. 开封: 河南大学, 2023.
[43] 《儿童青少年糖尿病营养治疗专家共识(2018版)》编写委员会. 儿童青少年糖尿病营养治疗专家共识(2018版) [J]. 中华糖尿病杂志, 2018, 10(9): 569-577.
[44] Phelan, H., King, B., Anderson, D., Crock, P., Lopez, P. and Smart, C. (2018) Young Children with Type 1 Diabetes Can Achieve Glycemic Targets without Hypoglycemia: Results of a Novel Intensive Diabetes Management Program. Pediatric Diabetes, 19, 769-775. [Google Scholar] [CrossRef] [PubMed]
[45] 张倩, 杨振宇, 李瑞莉, 等. 中国0-18岁儿童营养与健康系统调查与应用——6-18岁儿童调查方案[J]. 卫生研究, 2022, 51(5): 703-706.
[46] 刘岩, 张馨月, 王祥香, 等. 人工智能在糖尿病患者饮食管理中应用的研究进展[J]. 预防医学论坛, 2023, 29(4): 315-320.
[47] 刘静. 1型糖尿病患儿碳水化合物管理APP的研发与应用研究[D]: [硕士学位论文]. 重庆: 重庆医科大学, 2024.
[48] Joubert, M., Meyer, L., Doriot, A., Dreves, B., Jeandidier, N. and Reznik, Y. (2021) Prospective Independent Evaluation of the Carbohydrate Counting Accuracy of Two Smartphone Applications. Diabetes Therapy, 12, 1809-1820. [Google Scholar] [CrossRef] [PubMed]

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