Caregivers’ Nutrition Knowledge and Dietary Intake of Type 1 Diabetic Children Aged 3–14 Years in Uganda

Figures & data

Table 1 Socio-Demographic Characteristics of Caregivers

Characteristics	n (%) or Mean ± SD (N=59)
Mean Age of Caregiver (Years)	38.4 ± 10.2
Caregiver age distribution (years)
≤ 25	6 (10.2)
26–29	3 (5.1)
30–35	12 (20.3)
36–39	11 (18.6)
≥ 40	27 (45.8)
Sex of caregiver
Male	18 (30.5)
Female	41 (69.5)
Relation to the child
Parent	50 (84.7)
Aunt/Uncle	1 (1.7)
Sibling/Cousin	6 (10.2)
Grandparent	2 (3.4)
Marital status
Single	8 (13.6)
Co-habiting/Married	47 (79.7)
Divorced/Widowed/Separated	4 (6.8)
Occupation of caregiver
Public sector	7 (11.9)
Private sector	19 (32.2)
Informal sector	32 (54.2)
Unemployed	1 (1.7)
Level of education
Primary	17 (28.8)
Secondary	20 (33.9)
University or higher	17 (28.8)
No formal education	5 (8.5)
Family size	5.9 ± 1.4

Abbreviation: SD, standard deviation.

Table 2 Socio-Demographic Correlates of Caregivers’ Level of Type 1 Diabetes Nutrition Knowledge and Child’s Dietary Diversity

Characteristics	Correlates of NKS Scores			Correlates of DDS
	β	(95% CI)	p-value	β	(95% CI)	p-value
Caregiver age distribution (years)
≤ 25	−6.774	(−47.821, 34.273)	0.738	−0.298	(−4.582, 3.985)	0.888
26–29	17.263	(−13.179, 47.704)	0.256	−0.645	(−3.822, 2.532)	0.681
30–35	4.949	(−10.010, 19.907)	0.504	−0.378	(−1939, 1.183)	0.624
36–39	−0.579	(−16.879, 15.721)	0.943	0.139	(−1.495, 1.773)	0.864
≥ 40	−0.344	(−12.622, 11.933)	0.955	−0.052	(−1.283, 1.179)	0.932
Age of caregiver (years)	−0.284	(−0.669, 0.101)	0.145	0.033	(−0.007, 0.073)	0.108
Sex of caregiver
Male	1.318	(−11.251, 13.887)	0.832	−0.259	(−1.571, 1.052)	0.689
Female	−3.475	(−14.329, 7.379)	0.520	0.084	(−1.004, 1.172)	0.876
Marital status
Single	−5.553	(−51.021, 39.915)	0.805	1.370	(−3.375, 6.115)	0.560
Co-habiting/Married	4.560	(−16.242, 25.361)	0.658	−0.354	(−2.525, 1.817)	0.741
Divorced/Widowed/Separated	−0.740	(−18.331, 16.859)	0.932	0.167	(−1.597, 1.930)	0.849
Relation to the child
Parent	−0.955	(−31.056, 29.147)	0.949	−1.291	(−4.433, 1.850)	0.408
Aunt/Uncle	−2.242	(−69.146, 64.662)	0.946	−3.289	(−10.271, 3.693)	0.344
Sibling/Cousin	19.386	(−19.593, 58.365)	0.320	−1.977	(−5.885, 1.930)	0.311
Grandparent	−23.615	(−57.994, 10.765)	0.172	3.120	(−0.326, 6.566)	0.075
Occupation of caregiver
Public sector	6.267	(−15.237, 27.771)	0.556	0.531	(−1.713, 2.775)	0.633
Private sector	6.713	(−7.013, 20.440)	0.326	0.156	(−1.276, 1.588)	0.826
Informal sector	−0.260	(11.474, 10.954)	0.963	−0.010	(−1.143, 1.114)	0.986
Level of education
Primary	1.928	(−17.850, 21.705)	0.844	1.380	(−0.684, 3.444)	0.182
Secondary	−2.339	(−21.701, 17,024)	0.807	1.642	(−0.378, 3.663)	0.107
University or higher	0.779	(−17.871, 19.430)	0.933	−0.049	(−1918, 1.821)	0.958
No formal education	−22.488	(−43.773, −1.203)	0.039*	−2.055	(−4.189, 0.078)	0.059
Family size	1.665	(−1.000, 4.331)	0.216	0.314	(0.037, 0.591)	0.027*

Note: *Significant correlation at 0.05 (2-tailed).

Abbreviations: β, beta coefficient; CI, confidence interval; NKS scores, type 1 diabetes nutrition knowledge survey; DDS, dietary diversity score.

Table 3 NKS Categories

NKS Score Categories	n (%) or Mean ± SD (N=59)
Low type 1 diabetes nutrition knowledge (≤ 50%)	55 (93.2)
Medium type 1 diabetes nutrition knowledge (51–75%)	4 (6.8)
High type 1 diabetes nutrition knowledge (≥ 76%)	0 (0)
Mean NKS score	30.2 ± 15.4

Abbreviations: NKS, type 1 diabetes nutrition knowledge survey; SD, standard deviation.

Table 4 Children’s T1D Related Characteristics

Characteristics	n (%) or Mean ± SD (N=61)
Mean age of child (years)	9.8 ± 3.2
Mean age of child (male)	9.2 ± 3.7
Mean age of child (female)	10.3 ± 2.5
Sex of child
Male	30 (49.2)
Female	31 (50.8)
^a Duration of T1D (years)
≤1	9 (14.8)
2–5	35 (57.4)
≥6	15 (24.6)
No response	2 (3.2)
Insulin regimen
≤ 2 times a day	15 (24.6)
≥ 3 times a day	41 (67.2)
No response	5 (8.2)
^b Family history of T1D
Yes	19 (32.2)
No	40 (67.8)
Family history of T1D relation to child
Aunt/Uncle	1 (5.3)
Sibling/Cousin	8 (42.1)
Grandparent	10 (52.6)

Notes: ^aDuration of T1D refers to the length of time since the child was first diagnosed; ^bFamily history of T1D means whether any other family member had been diagnosed with T1D.

Abbreviation: T1D, type 1 diabetes.

Table 5 Children’s Dietary Intake

Characteristics	n (%) or Mean ± SD (N=61)
DDS
Mean DDS	5.7 ± 1.6
Low DDS (≤ 4)	15 (24.6)
High DDS (≥ 5)	46 (75.4)
Dietary intake
Energy (kcal)	1666.7 ± 639.8
Carbohydrate (g)	283.6 ± 109.7
Protein (g)	54.1 ± 28.9
Fat (g)	39.6 ± 38.2
Nutrient energy contribution (%)
Carbohydrate (45–50)	68.6 ± 15.4
Protein (15–20)	12.8 ± 4.7
Fat (<35)	18.5 ± 12.8
Nutrient adequacy ratio
Carbohydrate	0.9 ± 0.3
Protein	0.9 ± 0.4
Fat	0.5 ± 0.5
Vitamin A	0.4 ± 0.6
Vitamin B1	0.7 ± 0.5
Vitamin B2	0.6 ± 0.4
Vitamin B3	0.5 ± 1.0
Vitamin B5	0.5 ± 0.3
Vitamin B6	1.3 ± 1.1
Vitamin B12	0.6 ± 0.4
Biotin	0.3 ± 0.4
Folic acid	0.6 ± 0.4
Calcium	0.4 ± 0.3
Iron	1.0 ± 0.5
Zinc	1.0 ± 0.6
Mean adequacy ratio	0.7 ± 0.3

Abbreviations: DDS, dietary diversity score; SD, standard deviation.

Table 6 Correlation Between Dietary Diversity Score and Nutrient Adequacy Ratios, Mean Adequacy Ratio

Characteristics	DDS
NARs	Rho	p-value
Carbohydrate	0.316	0.013*
Fat	0.311	0.015*
Protein	0.416	0.001**
Vitamin A	0.315	0.013*
Vitamin B1	0.130	0.317
Vitamin B2	0.457	0.000**
Vitamin B3	0.290	0.024*
Vitamin B5	0.293	0.022*
Vitamin B6	0.062	0.637
Vitamin B12	0.395	0.002*
Biotin	0.182	0.160
Folic acid	0.317	0.016*
Calcium	0.130	0.319
Iron	0.127	0.330
Zinc	0.348	0.006*
MAR	0.299	0.019*

Notes: *Significant correlation at 0.05 (2-tailed); **Significant correlation at 0.01 (2-tailed).

Abbreviations: DDS, dietary diversity score; SD, standard deviation; NARs, nutrient adequacy ratios; MAR, mean adequacy ratio; rho, correlation coefficient.

Table 7 Correlation Between Caregivers’ Nutrition Knowledge Scores and DDS, Macronutrient Intake, NARs and MAR

Characteristics	NKS Scores
	Rho	p-value
DDS	0.131	0.323
Energy intake	0.239	0.068
Protein intake	0.193	0.143
Fat intake	0.129	0.332
Carbohydrate NAR	0.163	0.218
Protein NAR	0.193	0.143
Fat NAR	0.129	0.332
Vitamin A NAR	0.057	0.666
Vitamin B1 NAR	0.226	0.085
Vitamin B2 NAR	0.148	0.263
Vitamin B3 NAR	0.114	0.391
Vitamin B5 NAR	0.210	0.111
Vitamin B6 NAR	0.255	0.051
Vitamin B12 NAR	−0.090	0.498
Biotin NAR	0.385	0.003**
Folic acid NAR	0.307	0.018*
Calcium NAR	0.053	0.691
Iron NAR	0.244	0.063
Zinc NAR	0.170	0.198
MAR	0.187	0.156

Notes: *Significant correlation at 0.05 (2-tailed); **Significant correlation at 0.01 (2-tailed).

Abbreviations: NKS, type 1 diabetes nutrition knowledge survey; DDS, dietary diversity score; rho, correlation coefficient; NAR, nutrient adequacy ratio; MAR, mean adequacy ratio.

Table 8 Associations of Dietary Diversity Score and Socio-Demographic, Type 1 Diabetes Nutrition Knowledge and Type 1 Related Characteristics in Simple and Multiple Regression Models

Characteristics	Simple Regression		Multiple Regression
	β (95% CI)	p-value	β (95% CI)	p-value
Age of caregiver (years)			0.033 (−0.007, 0.073)^b	0.108
Family size			0.314 (0.037, 0.591)^b	0.027*
NKS scores	0.012 (−0.15, 0.039)^a	0.389	0.011 (−0.017, 0.039)^b	0.425
Duration of T1D (years)
≤ 1			−0.091 (−1.714, 0.914)^c	0.544
2–5			−0.328 (−2.019, −0.096)^c	0.032*

Notes: *Significant correlation at 0.05 (2-tailed); ^aSimple regression (DDS against NKS scores); ^bMultiple regression (DDS against NKS, family size and age of caregiver); ^cMultiple regression (DDS against duration of T1D).

Abbreviations: β, beta coefficient; CI, confidence interval; NKS scores, type 1 diabetes nutrition knowledge; DDS, dietary diversity score.