| Previous studies have documented metabolic abnormalities in individuals with spinal muscular atrophy (SMA). This study investigated the impact of diet and fasting on blood glucose levels using a continuous blood glucose monitor (CGM) in conjunction with detailed food diaries in a small cohort (N=8) of children with SMA type II. Children ages 9 to 16 years, without any previous diabetes diagnoses or interventions, participated in the study. The study was completed in two parts; a one-time outpatient visit and a 4-day at-home portion. During the outpatient visit, fasting insulin, fasting glucose, and hemoglobin A1c (HgA1c) laboratory tests were obtained and the CGM was inserted. Anthropometric measurements including height, weight, triceps skin fold, and assessment of body composition using bioelectrical impedance analysis (BIA) were collected. Following the outpatient visit, participants tracked dietary intake and maintained the CGM for 4 days at home. For 1 day of the study, participants consumed a prescribed specialized diet comprised of 45.6% of total caloric intake from carbohydrates and adequate fiber intake (26.4g). Data analysis was both descriptive and exploratory. Seven of 8 participants were overfat according to BIA analysis. Although not statistically significant, blood glucose variation decreased 0.50 mg/dL for every gram of fiber consumed. Upon visual analysis, dietary intervention seemed to have a moderating effect on blood glucose levels of participants with varying metabolic control, as indicated by homeostatic model assessment for insulin resistance calculations. Additionally, overfatness was common among participants and may correlate with blood glucose variability as BMI percentile increases. Implementing dietary recommendations for patients with SMA type II to increase daily fiber intake may prove beneficial for blood glucose regulation. Additionally, counseling to maintain adequate weight as assessed by both CDC BMI-for-age and body composition methods could improve patient blood glucose control in patients with SMA type II. Further research is required in order to determine significance of dietary intervention in children with SMA type II for the improvement of metabolic health. |
