Rukiye BOZBULUT, Esra IRMAK, Zeynep Bengisu EJDER, Nevin ŞANLIER
Journal of Medicine and Palliative Care - 2026;7(2):240-248
Aims: Dietary energy density plays a significant role in the development of chronic diseases; however, studies examining the effects of dietary energy density on individuals with type 1 diabetes are limited in the literature. This study aimed to investigate the effects of dietary energy density on glycemic control, quality of life, and sleep quality in adolescents with type 1 diabetes. Methods: The study included 112 adolescents (56 boys, 56 girls) aged 13-18 years with type 1 diabetes. HbA1c values were measured, anthropometric measurements were taken, and three-day retrospective food intake records were collected. Dietary energy densities (DED) were calculated and assigned to tertiles. The Pediatric Quality of Life Inventory (PEDSQLTM) Diabetes Module Version 3.0 report for adolescents aged 13-18 years was used to assess quality of life. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: As dietary energy density increased, the PSQI score increased (p=0.003), HbA1c levels increased (7.8+/-1.00 in the first tertile; 9.8+/-2.29 in the third tertile) (p<0.001), and treatment adherence decreased (p=0.036). The BMI-Z score also increased significantly with dietary energy density (p=0.032). Body fat percentage (p=0.047) was found to be higher, lean mass (p=0.002), and muscle mass (p=0.001) were found to be lower in tertiles with high dietary energy density compared to tertiles with low dietary energy density. Conclusion: Dietary energy density is associated with glycemic control, quality of life and sleep, and body weight in adolescents with type 1 diabetes. When planning the nutrition of children and adolescents with type 1 diabetes, the energy densities of foods should also be taken into consideration.
