RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
18
VOLUME 7 NUMBER 1 • MARCH 2010
Anthropometry
Weight and height measurements were taken in light clothing
and without shoes, using standard methods.
18
Weight was
measured using the A&D Personal Precision Digital Scale (UC-
321) to the nearest 0.5 kg. Height was measured using a
portable stadiometer with a sliding headpiece and a locking
device to the nearest 5 mm. Three measurements each were
taken for both weight and height and an average value was
calculated. Body mass index (BMI) for age was calculated
using the height and weight measurements obtained. BMI-
for-age
z
-scores (standard deviations of the median of the
reference population)
19
were calculated using the Epi Info
2005 software package, which is based on data from the
Center for Disease Control and Prevention (CDC), USA
(2000).
20
Statistical analysis
Diet-related knowledge multiple-choice questionnaires were
analysed to determine the frequency of the correct answers
and then calculated as a percentage. The SPSS software
programme (version 13.0) was also used to analyse data.
Diet-related knowledge scores were analysed using two-
sample
t
-tests and analysis of variance (ANOVA) tests. Pearson
correlation analysis was used to examine the relationships
between diet-related knowledge scores and quantitative
variables.
Ethical approval
Ethical approval (ref H263/05) was obtained from the
Biomedical Research Ethics Committee of the Nelson R
Mandela School of Medicine, University of KwaZulu-Natal.
Written consent to participate in the study was obtained
from the caregivers of the subjects.
Results
Table 1 shows the characteristics of the study subjects. Of
the total sample, 27% (
n
=
8) were from the Grey’s Hospital
clinic and 73% (
n
=
22) were from the IALCH clinic. Of the
total sample, 43% (
n
=
13) were female and 57% (
n
=
17)
were male. The sample comprised Africans (33%,
n
=
10),
coloureds (10%,
n
=
3), Indians (47%,
n
=
14) and whites
(10%,
n
=
3). The mean age was 8.56
±
1.45 years and the
mean duration since diagnosis was 3.61
±
2.25 years.
Table 2 shows the results of the diet-related knowledge
multiple-choice questions. Most subjects seemed to know
what to do if blood sugar levels went low (93.3%) and the
effect on blood sugar with eating too many sweets when
hungry (90%). The majority of subjects (86.7%) knew the
consequences of not taking their insulin injections every day,
how many meals should be eaten during the day (83.3%)
and the effect on blood sugar level if they did not eat for a
long time or skipped a meal (83.3%). The majority of subjects
also knew the correct amount of fruit that they could have as
a snack (86.7%) and that a small fruit would be the best buy
from the tuck shop (86.7%).
Areas that appeared to be problematic, where less than half
of the subjects responded correctly included: the importance
of having a late-night snack (46.7%), foods that are examples
of starch or carbohydrate (46.7%), the importance of fibre in
the diet (43.3%) and foods that are good sources of fibre
(46.7%). The mean diet-related knowledge score for the
sample was 67% (SD
±
18%) and the scores ranged between
30 and 100%.
When the sample was split at eight years, there was a
significant difference between the mean score of the children
≥
six and
<
eight years of age and children
≥
eight and
≤
10 years of age (Table 3), with the older children scoring
significantly higher than the younger children (76 vs 61%,
p
=
0.028).
There was a significant difference in mean scores between
the two hospital clinics (Table 4) with subjects from IALCH
scoring significantly higher than the subjects from Grey’s
Hospital (71 vs 56%,
p
=
0.038). There were no significant
relationships between the diet-related knowledge scores and
any of the other variables investigated.
The anthropometric status of the subjects is shown in Table
5. Eighteen of the 30 subjects had a healthy weight, one
was underweight, two were overweight, nine were at risk of
overweight and four were stunted. None of the subjects were
found to be wasted (i.e. had a weight-for-height
z
-score
<
–2
SD of the median of the reference population).
19
Discussion
In order to keep the questionnaire a reasonable length,
it focused on only certain dietary areas and was not a
comprehensive test of all dietary aspects that are important
in relation to diabetes management. It can therefore be
said that the sample population had a relatively good
knowledge of the diet-related aspects that were covered in
the questionnaire. The overall diet-related knowledge score
for the sample was in contrast to findings from other older
studies,
3,5-7
which all showed shortfalls in diabetes and diet-
related knowledge among children with type 1 diabetes. A
more recent study
2
did report an overall knowledge score of
73% among subjects attending a diabetes camp, which is
Table 1.
Characteristics of the study subjects (
n
=
30)
n
%
Hospital clinic
Grey’s
IALCH
8
22
27
73
Age
6–8 years
9–10 years
18
12
60
40
Gender
Males
Females
13
17
43
57
Race
African
Coloured
Indian
White
10
3
14
3
33
10
47
10
