Dietary compliance in children and adolescents with type 1 diabetes mellitus: A Systematic review of the literature

Managing Type 1 Diabetes (T1D) in children and adolescents is a complex process, with nutrition playing a crucial role in glycemic control and long-term health outcomes. However, adherence to dietary recommendations is often suboptimal, influenced by various individual and environmental factors. This study aims to evaluate the level of adherence to dietary guidelines among school-aged children and adolescents with T1D, and to identify key factors that influence this adherence. A systematic review was conducted following PRISMA guidelines, including primary studies published between 2005 and 2025. Databases such as PubMed and ScienceDirect were searched using predefined inclusion and exclusion criteria. A total of 21 studies involving participants aged 5 to 18 years were included. Findings revealed generally poor dietary adherence among children and adolescents with T1D. Common issues included low intake of fiber, fruits, and vegetables, and high consumption of saturated fats and processed foods. Compliance is influenced by various factors, such as psychological aspects (e.g., food neophobia, eating disorders), family support and dynamics, socioeconomic status and the availability of structured nutritional education. Interventions that incorporated family involvement and behavior-based strategies showed more promising outcomes in improving both dietary adherence and glycemic control. Despite established dietary recommendations, adherence remains low among youth with T1D across various populations. Effective strategies should address not only nutritional education but also psychological, familial, cultural, and structural barriers to promote sustainable dietary behaviors and improve health outcomes.

Keywords: type 1 diabetes, dietary adherence, children, Adolescents, glycemic cotrol