223-OR: Preliminary Evidence that "Structured Eating" (SE) May Be Acceptable and Promote Glycemic Control in Type 1 Diabetes (T1D)

Research on eating patterns in T1D is scarce, especially in youth. This population is in particular need of effective behavioral strategies during adolescence when HbA1c peaks and lifelong behaviors form. Case studies from pediatric T1D clinics suggest SE (consistent frequency, timing and spacing of meals, snacks and macronutrients throughout the day) is helpful for meeting glycemic targets, yet the health impacts and feasibility of SE as a clinical guideline are not well documented. We developed SE variables and used linear mixed effects models to explore associations between individual SE behaviors and CGM metrics in 24-hr dietary recall and 7-day CGM data of adolescents (n=319, 13-16 yrs, HbA1c 8-13%) from the Flexible Lifestyles Empowering Change (FLEX) intervention. We also conducted a small pilot (n=9, 13-16 yrs, HbA1c 8-13%), “MyPlan”, to explore acceptability of SE. In FLEX, SE behaviors were associated with favorable CGM profile, including time in range (Table 1). In MyPlan, acceptability of SE (scale 0-8) was high among adolescents (mean: 6.8; SE:1.6) and their parents (mean: 7.1 SE: 1.2). Our preliminary evidence suggests benefit and feasibility of SE in adolescents. To inform future trials and ultimately, clinical guidelines, further analyses in diverse samples are needed to more specifically characterize SE patterns and understand their role in T1D health outcomes. Disclosure A. Cristello: None. A.R. Kahkoska: Other Relationship; Self; Novo Nordisk A/S. C.E. Smart: None. S.C. Couch: None. D. Igudesman: None. L. Kager: None. E.J. Mayer-Davis: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1UC4DK101132)