Nutrition Literacy: What Are Young Adults With Type-1 Diabetes Missing?

Introduction: This study evaluated the nutrition literacy and perceived emotional burden of disease in young adults with type-1 diabetes. All participants are current or past members of the non-profit organization The Diabetes Link, formally known as the College Diabetes Network. The Diabetes Link is a 501(c)(3) nonprofit organization working to connect and support young adults with type-1 diabetes through the transitional periods of their lives, most commonly the transition from high school to college. Previous research shows that there is a significant uptick in glycated hemoglobin (HbA1c) levels in people with type-1 diabetes between the ages of 18 and 24, a period associated with many transitional events. While there are numerous hypothesized reasons why HbA1c levels spike during these ages, the lack of nutritional knowledge is frequently highlighted as a root cause of this increase. Methods: Participants were asked to complete a 40-question survey via Google Forms (Google LLC, Mountain View, California, United States) that contained questions pertaining to their treatment, dietary habits, confidence in healthcare professionals to provide nutrition advice, and overall feelings toward their diagnosis of type-1 diabetes. The survey also included four questions aimed at evaluating the participants' carbohydrate-counting skills to determine a basis of their nutritional knowledge. A binary logistic regression was performed using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States) to assess the influences of the burden and carbohydrate-counting knowledge on the participants’ diabetes care, eating habits, and emotional outlook on nutrition. Results: Data from this study show that the participants who scored high on the carbohydrate-counting quiz were 2.389 times more likely to avoid eating because of an out-of-range blood sugar level (p-value = 0.05), and the participants who reported higher levels of burden were 9.325 times more likely to avoid social gatherings because of food (p-value = 0.002). Conclusion: Results from this study demonstrate that the emotional burden associated with eating and not nutrition knowledge could contribute to the previously listed spike in HbA1c levels.