Impact of Culturally Tailored Diabetes Self-management Education on the Dietary Practices among Children with Type 1 Diabetes: A Comparative Study from Resource-constrained Settings in North India

Introduction: Dietary practices remain one of the most difficult components of diabetes self-management to modify and sustain.This study aimed to evaluate the impact of culturally tailored diabetes self-management education (DSME) on dietary practices among children with type 1 diabetes (T1D).Materials and methods: A total of 122 children were enrolled in this 2-month, comparative cross-sectional study in a North Indian tertiarycare hospital, including children (1-18 years) with T1D, grouped as DSME-received (n = 61) and newly diagnosed children without DSME (n = 61).The dietary habits and consumption of junk food were compared to assess the influence of DSME on dietary behavior.Children with prior DSME (6 months earlier) attended at least two structured dietary sessions.Caregiver interviews were conducted to collect the data using a validated questionnaire.Results: The two groups were comparable at baseline, with mean ages of 7.1 3.46 years (no DSME) and 8.0 4.71 years (DSME) (p = 0.240), and male proportions of 39.3 and 49.2% (p = 0.274).Parents in the DSME group showed better diet knowledge, including preferred snacks for sugar control (88.5 vs 63.9%, p = 0.001) and checking food labels (77 vs 41%, p < 0.001).Dietary practices were mostly similar, though DSME improved carbohydrate-related behaviors.Junk food patterns differed, with higher beverage (p = 0.047) and snack-type intake (p = 0.005) in the no DSME group, indicating healthier habits after DSME.Conclusion: Thus, children exposed to structured DSME demonstrated significantly superior carbohydrate-related knowledge, healthier dietary practices, and lower consumption of junk food compared to newly diagnosed children.