Background Nutritional management is central to pediatric type 1 diabetes (T1DM). The Dietary Inflammatory Index (DII) quantifies the inflammatory potential of diet, but evidence in pediatric T1DM remains limited. This study evaluated whether higher DII scores are associated with poorer glycemic control and adverse inflammatory profiles in children and adolescents with T1DM. Methods Seventy-eight pediatric patients with T1DM (5–19 years; 59.0% girls) were evaluated using 3-day dietary records, anthropometry, and biomarkers including HbA1c, lipid profile, and inflammatory/adipokine markers (CRP, IL-6, TNF-α, leptin, adiponectin). DII scores were calculated from dietary intake data. Associations between DII and outcomes were tested using covariate-adjusted general linear models controlling for age, sex, BMI, energy intake, and diabetes duration. Results In adjusted models, higher DII was independently associated with higher HbA1c (B = 0.48; 95% CI 0.32–0.63; p < 0.001), LDL-C (B = 7.62; 95% CI 5.36–9.87; p < 0.001), TNF-α (B = 150.58; 95% CI 127.99–173.17; p < 0.001), and leptin (B = 730.60; 95% CI 629.14–832.06; p < 0.001), and with lower adiponectin (B = − 70.15; 95% CI − 79.93 to −60.37; p < 0.001). Higher DII showed greater energy, total fat, saturated fat, and cholesterol, and lower fiber, vitamin A, omega-3, vitamin E, and β-carotene. Conclusions More pro-inflammatory dietary profiles were associated with worse metabolic control and higher inflammatory burden, supporting DII as a clinically relevant dimension in pediatric T1DM nutritional assessment. Impact <UnorderedList Mark="Bullet"> <ItemContent> In children/adolescents with T1DM, higher DII is linked to poorer metabolic status, worse glycemic control, and higher BMI/body-composition risk markers. </ItemContent> <ItemContent> In covariate-adjusted models, higher DII is independently associated with higher HbA1c and LDL-C and with an unfavorable adipokine/inflammatory profile (higher TNF-α and leptin, lower adiponectin). </ItemContent> <ItemContent> These associations persist after adjusting for age, sex, BMI, energy intake, and diabetes duration, indicating an independent association with cardiometabolic/inflammatory burden. </ItemContent> <ItemContent> Nutrition care may incorporate dietary inflammatory potential alongside carbohydrate counting; more fiber, unsaturated fats/omega-3, antioxidants; less saturated/ultra-processed foods may be relevant to prospective/interventional testing, potentially to improve long-term pediatric outcomes. </ItemContent> </UnorderedList>

Dietary Inflammatory Index and cardiometabolic and inflammatory profiles in children and adolescents with type 1 diabetes: a cross-sectional study

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2026年5月8日

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İsmail Mücahit Alptekin,
Tuba Ekinci Gezmiş,
Fatma Betül Özgeriş,
Zehra Şahin,
Nurinnisa Öztürk,
Zerrin Orbak

摘要

Background

Nutritional management is central to pediatric type 1 diabetes (T1DM). The Dietary Inflammatory Index (DII) quantifies the inflammatory potential of diet, but evidence in pediatric T1DM remains limited. This study evaluated whether higher DII scores are associated with poorer glycemic control and adverse inflammatory profiles in children and adolescents with T1DM.

Methods

Seventy-eight pediatric patients with T1DM (5–19 years; 59.0% girls) were evaluated using 3-day dietary records, anthropometry, and biomarkers including HbA1c, lipid profile, and inflammatory/adipokine markers (CRP, IL-6, TNF-α, leptin, adiponectin). DII scores were calculated from dietary intake data. Associations between DII and outcomes were tested using covariate-adjusted general linear models controlling for age, sex, BMI, energy intake, and diabetes duration.

Results

In adjusted models, higher DII was independently associated with higher HbA1c (B = 0.48; 95% CI 0.32–0.63; p < 0.001), LDL-C (B = 7.62; 95% CI 5.36–9.87; p < 0.001), TNF-α (B = 150.58; 95% CI 127.99–173.17; p < 0.001), and leptin (B = 730.60; 95% CI 629.14–832.06; p < 0.001), and with lower adiponectin (B = − 70.15; 95% CI − 79.93 to −60.37; p < 0.001). Higher DII showed greater energy, total fat, saturated fat, and cholesterol, and lower fiber, vitamin A, omega-3, vitamin E, and β-carotene.

Conclusions

More pro-inflammatory dietary profiles were associated with worse metabolic control and higher inflammatory burden, supporting DII as a clinically relevant dimension in pediatric T1DM nutritional assessment.

Impact

In children/adolescents with T1DM, higher DII is linked to poorer metabolic status, worse glycemic control, and higher BMI/body-composition risk markers.

In covariate-adjusted models, higher DII is independently associated with higher HbA1c and LDL-C and with an unfavorable adipokine/inflammatory profile (higher TNF-α and leptin, lower adiponectin).

These associations persist after adjusting for age, sex, BMI, energy intake, and diabetes duration, indicating an independent association with cardiometabolic/inflammatory burden.

Nutrition care may incorporate dietary inflammatory potential alongside carbohydrate counting; more fiber, unsaturated fats/omega-3, antioxidants; less saturated/ultra-processed foods may be relevant to prospective/interventional testing, potentially to improve long-term pediatric outcomes.