Examining mealtime behaviors in families of young children with type 1 diabetes on intensive insulin therapy

• Intensive insulin therapy allows for more flexible eating at mealtimes.
• Young children on intensive insulin therapy were disruptive at mealtimes.
• Parents of young children engaged in ineffective mealtime management strategies.
• Children's disruptive behaviors relate child average glycemic control.
• Families reporting mealtime problems should be referred for behavior therapy.

This study examined mealtime behaviors in families of young children with type 1 diabetes (T1DM) on intensive insulin therapy. Behaviors were compared to published data for children on conventional therapy and examined for correlations with glycemic control. Thirty-nine families participated and had at least three home meals videotaped while children wore a continuous glucose monitor. Videotaped meals were coded for parent, child, and child eating behaviors using a valid coding system. A group difference was found for child request for food only. There were also associations found between children's glycemic control and child play and away. However, no associations were found between parent and child behaviors within meals and children's corresponding post-prandial glycemic control. Results reinforce existing research indicating that mealtime behavior problems exist for families of young children even in the context of intensive therapy and that some child behaviors may relate to glycemic control.