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. 2025:2025:4108685.
doi: 10.1155/pedi/4108685. Epub 2025 Mar 28.

Patient Characteristics Associated With Annual Nutrition Visits in Children With Type 1 Diabetes

Svetlana Azova  1   2 , Belinda S Lennerz  1   2 , Carter R Petty  3 , Erin Gordon  4 , Hannah Michelson  1 , Anna Schmidt  1 , Katharine Garvey  1   2 , Erinn T Rhodes  1   2
Affiliations

Patient Characteristics Associated With Annual Nutrition Visits in Children With Type 1 Diabetes

Svetlana Azova et al. Pediatr Diabetes. 2025.

Abstract

Objective: Diabetes organizations recommend nutrition education by a registered dietitian (RD) at least annually following type 1 diabetes (T1D) diagnosis in children. The study objectives were to describe differences over time in annual RD follow-up in children with T1D and to identify patient characteristics associated with RD engagement.

Research design and methods: Data based on 6034 completed diabetes medical visits among 1982 patients aged <18 years with T1D for ≥1 year followed at a pediatric, tertiary care, academic medical center over a 5-year period (2018-2022) were analyzed. Generalized estimating equations models assessed for differences over time in the rates of RD visit completion in the year preceding the last diabetes medical encounter and identified sociodemographic, diabetes care-related, and clinical patient characteristics associated with RD follow-up. Models were fit for the whole sample and groups subset by race and ethnicity.

Results: Observed annual RD follow-up rate over the 5-year period was 20.8%, with the lowest adjusted percentage in 2021 compared to 2018. In multivariable analysis, for each year increase in age (p = 0.004) and diabetes duration (p<0.001), there was a 3% and 15% reduction in the odds of RD follow-up, respectively. RD follow-up was associated with lower hemoglobin A1c within the subsequent year in adjusted analysis (p = 0.029), with the greatest improvement among Hispanic patients.

Conclusions: Annual RD visit frequency among children with T1D is suboptimal. Study findings provide insights for targeted intervention to improve RD engagement. RD follow-up may be associated with improved glycemic outcomes.

Keywords: healthcare utilization; medical nutrition therapy; patient care; pediatric; registered dietitian; type 1 diabetes.

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Conflict of interest statement

Conflicts of Interest The authors declare no conflicts of interest.

Figures

Figure 1:
Figure 1:
Adjusted annual percentages of established pediatric patients with type 1 diabetes with ≥1 registered dietitian visit in the preceding year between 2018 and 2022. Data are presented for the whole sample and when subset by race and ethnicity. *Values in these years differed significantly from 2018, p<0.05.
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