Caregiver and Patient Experiences With the Diabetes Care Team Impact Utilization of Medical Nutrition Therapy in Pediatric Type 1 Diabetes.

PURPOSE: The purpose of the study was to understand how patient/family experiences with the diabetes care team impact medical nutrition therapy (MNT) utilization in pediatric type 1 diabetes (T1D).

METHODS

Utilizing a qualitative descriptive research design augmented by phenomenological principles, we conducted supplementary analysis of data collected during semi-structured interviews with caregivers of children with T1D <18 years and youth with T1D ages 12 to 17 years with T1D duration ≥1 year. Interview guides were informed by the socioecological framework, with 1 section dedicated to the exploration of patient/caregiver MNT-based experiences with the diabetes care team.

RESULTS

Qualitative analysis of data from 18 completed interviews (9 caregivers, 9 patients) yielded important themes with regard to how experiences with the diabetes care team influence MNT utilization in the child with T1D. These included (1) dissatisfaction and confusion regarding nutrition education at the time of T1D diagnosis, (2) misalignment of nutrition goals/lack of perceived utility during outpatient T1D visits, (3) observed gaps in nutritional counseling during outpatient T1D visits, and (4) opportunities to optimize patient/family nutrition experiences with the outpatient diabetes care team.

CONCLUSIONS

This study produced important insights into the impact of patient/caregiver interactions with the diabetes care team on MNT perceptions and experiences. Initiatives aimed at strengthening and individualizing nutrition education are imperative in optimizing MNT utilization in pediatric T1D.