Effect of the introduction of dietary sucrose on metabolic control in children and adolescents with type I diabetes

Abstract

The effect of sucrose in the diet of children and adolescents with type I diabetes on long-term metabolic control was studied. For a mean observation period of 83 (range 42–127) days, a diet containing 5% of total calories as refined sugar was recommended to 11 children (group A, mean age 15.0, SD 5.4 years), while another 13 children remained on their usual ‘sucrose-free’ diet (group B, mean age 16.0, SD 5.7 years). The mean observation period in this group was 77 (41–103) days. All children had a dietary assessment at baseline and at follow up using a 7-day food record. At baseline, sucrose intake as a proportion of total daily calories was similar in the two groups (group A 1.4, SD 1.9% vs group B 2.0, SD 2.3%;P=0.5). At follow-up, sucrose intake increased significantly in group A (5.1, SD 2.5%;P=0.0008), but not in group B (2.7, SD 3.3%;P=0.5). Metabolic control assessed by haemoglobin level (HbA_1c) was not different between the groups at baseline (group A 8.5, SD 1.2 vs group B 8.8, SD 1.8%;P=0.7) nor at follow-up (9.1, SD 1.4 vs 9.0, SD 2.5%;P=0.9). Within group A, the individual change in HbA_1c correlated with the individual change in sucrose intake (r=0.61,P=0.05), this correlation being strongly influenced by two individuals with an increase in sucrose consumption substantially exceeding 5%. Percentage intake of protein, carbohydrate and fat did not change significantly. Fibre consumption decreased with increasing consumption of sucrose in group A (r=−0.75,P=0.007). It is concluded that the introduction of sucrose in the diet of children and adolescents with type I diabetes up to 5% of the daily total calories has no negative effect on metabolic control but reduces the amount of fibre in the diet. Higher amounts of sucrose might have negative effects on metabolic control.