Nutritional Status, Dietary Intake, and Nutrition-Related Interventions Among Older Adults With Type 1 Diabetes (T1D): A Systematic Review and Call for More Evidence Toward Clinical Guidelines (2024)

Undergraduate: Gabriella Ercolino

Faculty Advisor: Anna Kahkoska
Department: Center for Aging and Health, UNC at Chapel Hill, Division of Endocrinology and Metabolism, School of Medicine, UNC at Chapel Hill, Medicine, School of Medicine, UNC at Chapel Hill, Nutrition, UNC Gillings School of Global Public Health

---

There is a growing number of older adults (≥ 65 years) living with type 1 diabetes (T1D). Optimizing health through nutrition during this life stage is challenged by concurrent changes in diabetes management, comorbidities, and lifestyle factors. There is a need to characterize nutritional status, dietary intake, and nutrition-related interventions that may promote well-being throughout the life span in T1D, in addition to nutrition recommendations from clinical guidelines and consensus reports. Three reviewers used Cochrane guidelines to screen original research (January 1993–2023) and guidelines (2012–2023) in two databases (MEDLINE and CENTRAL) to characterize nutrition evidence in this population. We found limited original research explicitly focused on nutrition and diet in adults ≥65 years of age with T1D (six experimental studies, five observational studies) and meta-analyses/reviews (one scoping review). In the majority of analyses individuals ≥65 years of age were combined with those age ≥18 years and also individuals with type 1 and type 2 diabetes were combined. Further, existing clinical guidelines (n = 10) lacked specificity and evidence to guide clinical practice and self-management in this population. From a scientific perspective, little is known about nutrition and diet among older adults with T1D, including baseline nutrition status, dietary intake and eating behaviors, and the impact of nutrition interventions on key clinical and patient-oriented outcomes. This likely reflects the population’s recent emergence and unique considerations. Addressing these gaps is foundational to developing evidence-based nutrition practices and guidelines for older adults living with T1D.

Link to Abstract