{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:14:55Z","timestamp":1788520495161,"version":"build-2803163510"},"reference-count":14,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nutr Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Type 1 diabetes mellitus (T1DM) care in children relies on insulin delivery and diet. Evidence on how delivery modality relates to meal-related behaviors in Saudi pediatric populations is limited.\n                    <jats:bold>Objective:<\/jats:bold>\n                    To compare dietary adherence patterns between continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) and examine associations with glycemic control (HbA1c).\n                    <jats:bold>Design, Setting &amp; Participants:<\/jats:bold>\n                    Cross-sectional study conducted at pediatric diabetes clinics at three hospitals in the eastern region of Saudi Arabia between September 2023 and March 2024. N\u2009=\u200992 children\/adolescents with T1DM.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Dietary behaviors were assessed using the Perceived Dietary Adherence Questionnaire (PDAQ) (days\/week; reverse scoring for high-sugar and high-fat items). Key behaviors included low-GI intake, fiber-rich starchy foods, and carbohydrate distribution. Group differences (CSII vs MDI) and associations with HbA1c\u2009&lt;\u20097% were tested (\u03c7\u00b2). Daily water intake (6\u20138 cups) was also examined in relation to HbA1c and insulin modality.\n                    <jats:bold>Results:<\/jats:bold>\n                    CSII was used by 40.2% and MDI by 59.8%. Dietary adherence did not differ by insulin modality (all\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&gt;\u20090.05). Greater intake of fiber-rich starchy foods was associated with HbA1c\u2009&lt;\u20097% (\u03c7\u00b2\u2009=\u200911.742,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Water intake was not associated with HbA1c (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&gt;\u20090.05) but differed by modality (\u03c7\u00b2\u2009=\u20097.246,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    In this cohort of Saudi children and adolescents with T1DM, insulin modality was not associated with overall dietary adherence; however, fiber-forward starch choices were linked to improved glycemia. Pediatric care should emphasize skills-based nutrition education (carbohydrate distribution, lower-GI, fiber-rich starches) across modalities. The modality-related hydration difference warrants an adjusted, longitudinal evaluation.\n                  <\/jats:p>","DOI":"10.1177\/02601060251395161","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T18:14:27Z","timestamp":1762884867000},"page":"1713-1720","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison between the continuous subcutaneous insulin infusion and multiple daily injection effect on dietary patterns among type 1 diabetic patients in Saudi Arabia"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0561-5773","authenticated-orcid":false,"given":"Amal","family":"Arishi","sequence":"first","affiliation":[{"name":"Imam Abdulrahman Bin Faisal University"},{"name":"Clinical Nutrition Department, Faculty of Nursing and Health Science, Jazan University, Jazan, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abuzaid","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman Bin Faisal University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"AlFaraj","sequence":"additional","affiliation":[{"name":"King Fahad Specialist Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-384X","authenticated-orcid":false,"given":"Haya Ahmed","family":"Al Guaimi","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Abdulrahman bin Faisal University, King Fahd Hospital of the University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6056-8616","authenticated-orcid":false,"given":"Reem","family":"Al Argan","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Abdulrahman bin Faisal University, King Fahd Hospital of the University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Alradhwan","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Centre, Dammam Medical Complex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malak","family":"Alkhalifah","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Centre, Dammam Medical Complex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah Adnan","family":"Alawami","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman bin Faisal University King Fahd Hospital of the University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1351-3538","authenticated-orcid":false,"given":"Maab","family":"Abualsaud","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman bin Faisal University King Fahd Hospital of the University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0962-9991","authenticated-orcid":false,"given":"Wesam","family":"Alyahya","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman Bin Faisal University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4010-1506","authenticated-orcid":false,"given":"Reham","family":"Metwally","sequence":"additional","affiliation":[{"name":"Imam Abdulrahman Bin Faisal University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_845_20"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1179551418825159"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu7075231"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114516003688"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/POC.0000000000000125"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-020-00831-z"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.12.013"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108516"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2021.782670"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15068"},{"issue":"3","key":"e_1_3_4_12_1","first-page":"154","article-title":"Type 1 diabetes: Management strategies","volume":"98","author":"Smith A","year":"2018","unstructured":"Smith A, Harris C (2018) Type 1 diabetes: Management strategies. American Family Physician 98(3): 154\u2013162. Available at: https:\/\/www.aafp.org\/pubs\/afp\/issues\/2018\/0801\/p154.pdf (accessed 29 August 2025).","journal-title":"American Family Physician"},{"key":"e_1_3_4_13_1","unstructured":"Subramanian S Baidal D Skyler JS et al. (2021) The management of type 1 diabetes. NCBI Bookshelf [Online]. Available at: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279114\/ (accessed 29 August 2025)."},{"key":"e_1_3_4_14_1","unstructured":"U.S. Food and Drug Administration (2024) Pediatric medical devices. FDA [Online]. 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