(P25-015-25) Behavioral Goals for Eating Timing, Frequency, and Distribution of Carbohydrate Consumption Among Youth With Type 1 Diabetes (MyPlan): A Pilot and Feasibility Study

Objectives: We conducted a single-arm pilot and feasibility trial to explore the feasibility and diabetes management benefits of the MyPlan eating behavior intervention among adolescents 12-17 year of age with type 1 diabetes >1 year and HbA1c 7.5-11%.

Methods: Youth (n=44, 59% Female, 68% non-Hispanic White, mean age 14.7 [SD = 1.6] years, type 1 diabetes duration 6.1 [SD = 3.7] years, HbA1c 8.7 [SD =1.3] %, and body mass index 24.5 [SD = 6.5] kg/m2) completed a 6-month behavior change intervention consisting of food logs and dietician guided sessions (8 weekly, 7 bi-weekly) focused on setting and revising action plans to adhere to five daily eating behavior goals (3-4 meals 0-2 snacks; meals/snacks 2-4 hours apart; meal/snack carbohydrate ranges; no post-dinner snack; meal/snack ≤2 hours of waking). Feasibility was assessed via measures of recruitment, retention, adherence (two unannounced 24-hour dietary recalls at baseline and endline), acceptability (endline 5-item diet acceptability instrument with previously demonstrated evidence of validity), adverse effects (weight loss, exacerbation of disordered eating, adverse events during participation), and data completion. Assessment of diabetes management benefits included HbA1c and youth and parent self-report. Analysis used descriptive statistics, paired t-tests, and McNemar’s tests.

Results: We observed excellent retention (85%), intervention attendance (15.8 [SD = 0.6] sessions/16 sessions), weekly food log adherence (4.0 [SD = 2.6] logs/≥3 logs per week), ≥90% data completion, and no adverse effects. Endline adherence to the majority (≥3) of goals was ≥90% according to two unannounced 24-hour dietary recalls. HbA1c decreased by an average of 0.3% (SD = 0.9, p = 0.03). The majority of youth (86%) and parents (93%) endorsed satisfaction with, ease of adoption, and sustainability of the eating behavior pattern.

Conclusions: Findings indicate feasibility and potential diabetes self-management benefits of the MyPlan eating behavior intervention for adolescents with type 1 diabetes and sub-optimal HbA1c, warranting progression to a trial to evaluate effectiveness.

Funding Sources: National Institute of Diabetes and Digestive and Kidney Diseases