Introdução: Ainda que pacientes apresentem irregular aceitação da via oral, a avaliação sistemática e precisa sobre a ingestão não está incorporada às rotinas assistenciais de enfermagem. Objetivo: Avaliar a concordância entre a aceitação da alimentação por via oral referida por pacientes e os registros em prontuário desta aceitação, assim como os diagnósticos e cuidados de enfermagem prescritos. Método: Em uma coorte de adultos cirúrgicos do Hospital de Clínicas de Porto Alegre, entre agosto de 2011 e outubro de 2012, foram avaliados inquéritos de ingestão alimentar por meio de recordatório de 24 horas, registros nos prontuários da ingestão alimentar pelos enfermeiros, diagnósticos de enfermagem (DE) e prescrição de cuidados referentes à nutrição. Considerou-se “boa aceitação”: ingestão ≥75% das calorias totais prescritas no dia; “regular aceitação”: 50 a 74,9%; “pouca aceitação”: <50% e NPO (nada por via oral), conforme prescrição médica. Adotou-se Coeficiente de Kappa para avaliação da concordância. Resultados: A proporção de respostas coincidentes entre o relato do paciente e registro do enfermeiro foi de 91,3% nas situações de NPO, 87,1% para “boa aceitação”, 17,8% para “regular aceitação” e 16,5% para “pouca aceitação” (Kappa = 0,45). Dos 3259 pacientes/dia, encontrou-se pelo menos um DE em 277 (8,5%) (103 para “boa aceitação”; 52 para “aceitação “regular”; 45 para “pouca aceitação”; 77 para sujeitos em NPO) e pelo menos um cuidado de enfermagem em 316 (9,7%) (116 para “boa aceitação”; 62 para “aceitação regular”; 67 para “pouca aceitação”; 71 para sujeitos em NPO). Conclusão: A concordância entre os relatos dos pacientes cirúrgicos e registros dos enfermeiros foi de moderada a fraca. Observou-se maior proporção de respostas coincidentes quando os pacientes relataram “boa aceitação” ou quando havia prescrição de NPO. Os diagnósticos e cuidados de enfermagem relacionados à nutrição não documentam a elevada prevalência de desnutrição hospitalar e a adequada aceitação da alimentação por via oral em adultos cirúrgicos hospitalizados. / Introduction: Even though patients demonstrate irregular acceptance of oral intake, a systematic and accurate evaluation of the intake is not included in the routines of nursing care. Objective: Evaluate the conformity between acceptance of oral intake referred by patients and the records about this acceptance, as well as nursing diagnoses (ND) and interventions prescribed. Method: Assessment of food intake by 24-hour recall, food intake recorded by nurses, ND and prescribed care related to nutrition were evaluated in a cohort of adult and surgical patients of Hospital de Clinicas de Porto Alegre between August 2011 and October 2012. It was considered "high acceptance”: intake ≥ 75% of total amount prescribed per day; "medium acceptance": 50 to 74.9%; "low acceptance": < 50 % and NPO (nothing by mouth), according to medical prescription. The Kappa coefficient of agreement was used for evaluation of conformity. Results: The proportion of matching responses between patients’ reports and nursing records was 91.3 % in cases of NPO, 87.1 % for "high acceptance", 17.8% for "medium acceptance" and 16.5% for "low acceptance" (Kappa = 0,45). Of the 3259 patients/day , it was found at least one ND in 277 (8.5%) (103 for "high acceptance", 52 for "medium acceptance", 45 for "low acceptance"; 77 for patients in NPO) and at least one nursing care in 316 (9.7%) (116 for "high acceptance", 62 for "medium acceptance”; 67 for "low acceptance"; 71 for patients in NPO). Conclusion: The conformity between surgical patients' reports and nursing records was moderate to weak. There was a higher proportion of matching responses when patients reported "high acceptance" or when NPO was prescribed. The diagnoses and nursing care related to nutrition do not document the high prevalence of hospital malnutrition and adequate acceptance of oral intake in hospitalized surgical adults. / Introducción: Aunque los pacientes presenten aceptación irregular de la dieta oral, una evaluación sistemática y precisa de la ingestión no está incluida en las prácticas assistenciales de enfermería. Objetivo: Evaluar la concordancia entre la aceptación de la dieta oral reportada por los pacientes y los registros en prontuario desta aceptación, así como el diagnóstico y los cuidados de enfermería prescritos. Método: Fueron evaluados el consumo de alimentos mediante recuerdo de 24 horas, los registros de la ingestión en prontuario por las enfermeras, los diagnósticos de enfermería (DE) y la prescripción de cuidados relativa a la nutrición en una cohorte de adultos quirúrgica del Hospital de Clínicas de Porto Alegre, entre agosto de 2011 y octubre de 2012. Se consideró "buena aceptación": la ingesta de ≥ 75% de las calorías totales prescritas por día, "regular aceptación": de 50 a 74,9%; "baja aceptación": < 50 % y NPO (nada por la boca), de acuerdo com la prescripción médica. Para la evaluación de la concordância, fue utilizado el coeficiente Kappa. Resultados: La proporción de respuestas coincidentes entre el relato del paciente y el registro de las enfermeras fue 91,3% en casos de NPO, 87,1% para "buena aceptación", 17,8% para "regular aceptación" y 16.5% para "baja aceptación" (Kappa=0,45). De los 3.259 pacientes/día, fue encontrado al menos un DE en 277 (8,5%) (103 para "buena aceptación", 52 para "regular aceptación", 45 para "baja aceptación", 77 para pacientes en NPO) y al menos un cuidado de enfermería en 316 (9,7%) (116 para "buena aceptación", 62 para "regular aceptación", 67 para "baja aceptación", 71 para los pacientes en NPO). Conclusión: La concordancia entre los relatos de los pacientes quirúrgicos y los registros de las enfermeras fue de moderada a débil. Hubo una mayor proporción de respuestas coincidentes cuando los pacientes informaron "buena aceptación" o cuando había NPO prescrito. Los diagnósticos y los cuidados de enfermería relacionados con la nutrición no documentan la alta prevalencia de la desnutrición hospitalaria y la aceptación adecuada de la alimentación oral en adultos quirúrgicos hospitalizados.

Introdução: Ainda que pacientes apresentem irregular aceitação da via oral, a avaliação sistemática e precisa sobre a ingestão não está incorporada às rotinas assistenciais de enfermagem. Objetivo: Avaliar a concordância entre a aceitação da alimentação por via oral referida por pacientes e os registros em prontuário desta aceitação, assim como os diagnósticos e cuidados de enfermagem prescritos. Método: Em uma coorte de adultos cirúrgicos do Hospital de Clínicas de Porto Alegre, entre agosto de 2011 e outubro de 2012, foram avaliados inquéritos de ingestão alimentar por meio de recordatório de 24 horas, registros nos prontuários da ingestão alimentar pelos enfermeiros, diagnósticos de enfermagem (DE) e prescrição de cuidados referentes à nutrição. Considerou-se “boa aceitação”: ingestão ≥75% das calorias totais prescritas no dia; “regular aceitação”: 50 a 74,9%; “pouca aceitação”: <50% e NPO (nada por via oral), conforme prescrição médica. Adotou-se Coeficiente de Kappa para avaliação da concordância. Resultados: A proporção de respostas coincidentes entre o relato do paciente e registro do enfermeiro foi de 91,3% nas situações de NPO, 87,1% para “boa aceitação”, 17,8% para “regular aceitação” e 16,5% para “pouca aceitação” (Kappa = 0,45). Dos 3259 pacientes/dia, encontrou-se pelo menos um DE em 277 (8,5%) (103 para “boa aceitação”; 52 para “aceitação “regular”; 45 para “pouca aceitação”; 77 para sujeitos em NPO) e pelo menos um cuidado de enfermagem em 316 (9,7%) (116 para “boa aceitação”; 62 para “aceitação regular”; 67 para “pouca aceitação”; 71 para sujeitos em NPO). Conclusão: A concordância entre os relatos dos pacientes cirúrgicos e registros dos enfermeiros foi de moderada a fraca. Observou-se maior proporção de respostas coincidentes quando os pacientes relataram “boa aceitação” ou quando havia prescrição de NPO. Os diagnósticos e cuidados de enfermagem relacionados à nutrição não documentam a elevada prevalência de desnutrição hospitalar e a adequada aceitação da alimentação por via oral em adultos cirúrgicos hospitalizados. / Introduction: Even though patients demonstrate irregular acceptance of oral intake, a systematic and accurate evaluation of the intake is not included in the routines of nursing care. Objective: Evaluate the conformity between acceptance of oral intake referred by patients and the records about this acceptance, as well as nursing diagnoses (ND) and interventions prescribed. Method: Assessment of food intake by 24-hour recall, food intake recorded by nurses, ND and prescribed care related to nutrition were evaluated in a cohort of adult and surgical patients of Hospital de Clinicas de Porto Alegre between August 2011 and October 2012. It was considered "high acceptance”: intake ≥ 75% of total amount prescribed per day; "medium acceptance": 50 to 74.9%; "low acceptance": < 50 % and NPO (nothing by mouth), according to medical prescription. The Kappa coefficient of agreement was used for evaluation of conformity. Results: The proportion of matching responses between patients’ reports and nursing records was 91.3 % in cases of NPO, 87.1 % for "high acceptance", 17.8% for "medium acceptance" and 16.5% for "low acceptance" (Kappa = 0,45). Of the 3259 patients/day , it was found at least one ND in 277 (8.5%) (103 for "high acceptance", 52 for "medium acceptance", 45 for "low acceptance"; 77 for patients in NPO) and at least one nursing care in 316 (9.7%) (116 for "high acceptance", 62 for "medium acceptance”; 67 for "low acceptance"; 71 for patients in NPO). Conclusion: The conformity between surgical patients' reports and nursing records was moderate to weak. There was a higher proportion of matching responses when patients reported "high acceptance" or when NPO was prescribed. The diagnoses and nursing care related to nutrition do not document the high prevalence of hospital malnutrition and adequate acceptance of oral intake in hospitalized surgical adults. / Introducción: Aunque los pacientes presenten aceptación irregular de la dieta oral, una evaluación sistemática y precisa de la ingestión no está incluida en las prácticas assistenciales de enfermería. Objetivo: Evaluar la concordancia entre la aceptación de la dieta oral reportada por los pacientes y los registros en prontuario desta aceptación, así como el diagnóstico y los cuidados de enfermería prescritos. Método: Fueron evaluados el consumo de alimentos mediante recuerdo de 24 horas, los registros de la ingestión en prontuario por las enfermeras, los diagnósticos de enfermería (DE) y la prescripción de cuidados relativa a la nutrición en una cohorte de adultos quirúrgica del Hospital de Clínicas de Porto Alegre, entre agosto de 2011 y octubre de 2012. Se consideró "buena aceptación": la ingesta de ≥ 75% de las calorías totales prescritas por día, "regular aceptación": de 50 a 74,9%; "baja aceptación": < 50 % y NPO (nada por la boca), de acuerdo com la prescripción médica. Para la evaluación de la concordância, fue utilizado el coeficiente Kappa. Resultados: La proporción de respuestas coincidentes entre el relato del paciente y el registro de las enfermeras fue 91,3% en casos de NPO, 87,1% para "buena aceptación", 17,8% para "regular aceptación" y 16.5% para "baja aceptación" (Kappa=0,45). De los 3.259 pacientes/día, fue encontrado al menos un DE en 277 (8,5%) (103 para "buena aceptación", 52 para "regular aceptación", 45 para "baja aceptación", 77 para pacientes en NPO) y al menos un cuidado de enfermería en 316 (9,7%) (116 para "buena aceptación", 62 para "regular aceptación", 67 para "baja aceptación", 71 para los pacientes en NPO). Conclusión: La concordancia entre los relatos de los pacientes quirúrgicos y los registros de las enfermeras fue de moderada a débil. Hubo una mayor proporción de respuestas coincidentes cuando los pacientes informaron "buena aceptación" o cuando había NPO prescrito. Los diagnósticos y los cuidados de enfermería relacionados con la nutrición no documentan la alta prevalencia de la desnutrición hospitalaria y la aceptación adecuada de la alimentación oral en adultos quirúrgicos hospitalizados.

Bakgrund. I omvårdnaden ska distriktssköterskan se till människans hela situation och omvårdnaden ska utföras på ett personcentrerat och säkert sätt. I hemsjukvården utförs vården i patientens hem, antingen i ordinärt eller särskilt boende. Trycksår är en vanlig vårdskada och nutritionen är viktig för att förebygga och behandla trycksår. Syftet var att beskriva i vilken utsträckning som distriktssköterskor i hemsjukvården använder nutritionsåtgärder som trycksårsbehandling. Metod. För att besvara syftet användes en kvantitativ design där redan insamlad data från en trycksårsmätning togs del av. Resultatet visade att nutritionsåtgärder användes som trycksårsbehandling till 65% av patienterna. Bland varannan distriktssköterska som inte använde nutritionsåtgärder framkom olika orsaker. Det var vanligare att nutritionsåtgärder användes vid risk enligt riskbedömningarna MNS och SF-MNA. De vanligast använda nutritionsåtgärderna var näringsdryck och extra mellanmål. Resultatet visade att det fanns skillnader i trycksårens svårighetsgrad i förhållande till boendeform. Slutsats. Det fanns utrymme för förbättringar i att använda nutritionsåtgärder vid trycksår. Nutritionen spelar en betydelsefull roll i behandlingen av trycksår och det är viktigt att riskbedömningar utförs. Genom att tidigt använda nutritionsåtgärder som trycksårsbehandling kan distriktssköterskan främja hälsa, förebygga sjukdom och skada samt minska patientens lidande. / Background. In Nursing Care, it's important to see to the whole perspective of the patient, and the care should be performed in a person-centred and safe way. The purpose was to describe district nurses [DN] using of nutrition therapy as treatment for patients with pressure ulcers in home healthcare. Method. A quantitative design, where material from an already collected pressure ulcer study, was used. The result showed that nutritional therapy was used as pressure ulcer treatment in 65% of the patients. Among every other DN who did not use nutritional therapy as treatment of pressure ulcer, various causes were identified. It was more common to use nutritional therapy when risks according to MNS and SF-MNA assessments were found. The most common nutrition therapies were nutritional drinks and extra snacks. The result showed that there were differences in the severity of pressure ulcers in relation to patients' housing type. Conclusion. There was room for improvements in using nutrition therapy as pressure ulcer treatment. Nutrition plays an important role in the prevention and treatment of pressure ulcer, and it's important that risk assessments are performed. By initiating nutritional treatment early, the DN can promote health, prevent disease and injury, and reduce the patient's suffering.

Background: Diabetes self-management education, including nutrition education (NE) is an essential component of diabetes management. Effective NE can assist individuals with type 2 diabetes mellitus (DM) in resource limited settings to improve their dietary self-care; an area cited among the most difficult with consequent improvement in health outcomes. Aim: To develop a NE programme that is tailored to the needs of adults with type 2 DM in a resource limited setting and to evaluate the programme's effectiveness on health outcomes. Setting: Makapanstad and Mathibestad community health centres in the Moretele sub-district, North West Province (South Africa). Methods: The study was done in three phases employing mixed methods research. Qualitative methods, using focus group discussions with 31 diabetic patients (a convenience purposive sample), and an open ended self-administered questionnaire with ten health professionals serving them, assessed the NE needs and preferences (phase 1). The data were analysed according to the framework approach. The results from the needs assessment were used to plan a tailored NE programme (phase 2). A randomised controlled trial (quantitative) with a sample of 82 patients (with HbA1c ≥ 8), allocated to either intervention or control groups, evaluated the effect of the NE programme (phase 3). Outcomes [HbA1c, dietary behaviours, blood lipids, blood pressure, body mass index (BMI), diabetes knowledge and attitudes towards diabetes and its treatment] were assessed at baseline, six months and 12 months respectively. An analysis of covariance (ANCOVA) compared the groups on measured outcomes using baseline values, age, gender, and clinic as covariates. Rank ANCOVA was used for dietary intake. The level of significance for all tests was set at α < 0.05 for a two-tailed test. Results: Needs assessment Diabetes related knowledge deficits and inappropriate dietary practices, including food portion control problems, inadequate intake of vegetables and fruits and unbalanced diets, were observed. Eight barriers and two facilitators to dietary adherence were identified. Financial constraint was the major barrier while social support was the major facilitator. NE recommendations included content related to the disease and diet, group education at the clinic, a competent educator, provision of education materials and inclusion of family members. The planned NE programme consisted of eight weekly training sessions and six follow-up sessions (monthly and bi-monthly), vegetable gardening demonstrations and education materials. Nutrition education programme effects: Seventy six participants (38 per group) completed the study. The differences in HbA1c (primary outcome) between the intervention and control groups were -0.62% (p=0.15) at six months and -0.67% (p=0.16) at 12 months. Few participants, four from the intervention group and one from the control group, achieved HbA1c target (<7%) at both six and 12 months, [(p=0.20), (p=0.36)] respectively. There were no significant between group differences in BMI, lipid profile and blood pressure at six months and 12 months. Starchy foods intake (median servings) were significantly lower in the intervention group compared to the control group, 9.3 vs. 10.8 (p=0.005) at six months and 9.9 vs. 11.9 (p=0.017) at 12 months. The proportion of participants growing own vegetables significantly increased in the intervention group compared to the control group 17/41 vs. 5/40 (p=0.003) at six months and 16/38 vs. 5/38 at 12 months. No significant group differences in the intake of energy, macronutrients, vegetable and fruits, sodium, cholesterol and fibre were observed at six and 12 months. Diabetes knowledge improved in the intervention group +0.95 (p=0.033) and +2.2 (p=0.000) when compared with the control group at six and 12 months respectively. There were no significant group differences in the attitudes towards diabetes and its treatment. Conclusions: The qualitative needs assessment provided insight for planning a tailored NE programme. The NE improved some dietary behaviours (starchy foods portion control and growing own vegetables) and diabetes knowledge. A non-significant lowering of HbA1c was observed. / Thesis (Phd)--University of Pretoria, 2013. / Human Nutrition / unrestricted

Source: Masters Abstracts International, Volume: 45-04, page: 1952. Adviser: R. Sue Day. Includes bibliographical references.

Orientador: Eliana Cotta de Faria / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T15:03:58Z (GMT). No. of bitstreams: 1 Kinchoku_Harumi_M.pdf: 2499549 bytes, checksum: e5ef36d494fba41f42bf6fe5ac2c96dc (MD5) Previous issue date: 2007 / Resumo: Os principais determinantes da dieta que elevam as concentraçoes de LDL-C sao as gorduras saturadas, gorduras trans e, em menor grau, o colesterol da dieta. O aumento relativo na proporçao de carboidratos resulta em dislipidemia caracterizada pelo aumento das concentrações plasmáticas de TG e VLDL-C, baixas concentrações de HDL-C, razão C:HDL aumentada e, algumas vezes, a presença de partículas de LDL-C pequenas e densas.O propósito deste estudo foi avaliar o impacto do aconselhamento nutricional exclusivo em portadores de dislipidemias,verificando a resposta entre sexos e entre faixas etárias (<60 anos e = 60 anos) e a influência do tempo no tratamento (3,6 e 12 meses). Participaram do estudo 129 sujeitos, 56 homens e 73 mulheres com idade entre 20 a 73 anos sem uso de medicaçao hipolipemiante por no mínimo 30 dias antes e durante o tratamento, e com pelo menos três meses de seguimento nutricional. Para hipercolesterolemia foi orientada a restrição de gorduras saturadas (<7% do VET) e colesterol (<200 mg/dL) e, para hipertrigliceridemia a restriçao de carboidratos simples, bebidas alcoólicas e, restrição de gorduras totais (<20% do VET) para TG>300 mg/dL. Na presença de sobrepeso ou obesidade foi orientada dieta hipocalórica com redução gradativa das calorias. As concentrações de colesterol (C), LDL-C, e triglicérides (TG) foram significativamente reduzidas na população estudada em 14%, 5%, 30% respectivamente. No primeiro trabalho, em que foi avaliada a influência do tempo de aconselhamento nutricional comparado ao período basal, as respostas significativas às orientações dietéticas com três meses foram: para C (-16%), LDL-C (-0,1%) e não HDL-C (-19%); com seis meses para C (-13%), TG (-30%), LDL-C (-9%), nao HDL-C (-17%), Castelli I (-14%) e Castelli II (-4%) e, com 12 meses para C (-14%), TG (-27%) e Castelli I (-13%). As concentrações plasmáticas de HDL-C e o peso corporal não se modificaram. Entre os sexos (trabalho 2) foi observado uma redução de 16% para C e 36% para TG em homens, e de 12% para C, 12% para LDL-C, e 26% para TG nas mulheres e, entre faixa etária de 15% para C, 2% para LDL-C e 33% para TG nos adultos e 14% para C nos idosos. O aumento na concentração de HDL-C foi significativa em homens em relação às mulheres (+5% e -4 %) com hiperlipidemia mista.Todos os participantes responderam ao aconselhamento nutricional reduzindo as concentrações de C, TG, LDL-C e a nao HDL-C. O tempo de orientação dietética não modificou as respostas em lípides e lipoproteínas plasmáticos; sendo o tempo de três meses suficiente para observar os efeitos benéficos da dieta. Um maior número de parâmetros foi reduzido com seis meses indicando que a partir de sexto mês houve um efeito mais abrangente da dieta. Homens e adultos foram mais responsivos à orientação nutricional. As respostas foram maiores que os coeficientes de variação biológico para cada parâmetro avaliado exceto para LDL-C.Recomenda-se a aplicação desta experiência terapêutica positiva em outros Serviços de Saúde por se tratar de uma terapia de baixo custo podendo também contribuir na prevenção e controle de doença cardiovascular / Abstract: The strongest dietary determinants of elevated LDL cholesterol concentrations are dietary saturated fatty acid and trans fatty acid intakes to a lesser extent, dietary cholesterol and excess body weight The aim of the present study was to evaluate the responses plasma lipid to nutritional counseling on dyslipidemic outpatients and analyze their responses by gender and age and analyzing the influence of time (3, 6 and 12 months) of treatment. One-hundred and twenty nine dyslipidemic subjects i.e. 56 males and 73 females aged 20 - 73 years comprised this study. No medication was used 30 days before and during following the diet as part of the inclusion criteria. Patients with hypercholesterolemia were oriented to follow the NCEP step 2 diet, and those with hypertriglyceridemia were oriented to restrict simple carbohydrates and alcoholic beverage and, in presence of TG >300 mg/dl, to use low fat diet (=20%). After nutritional counseling plasma cholesterol (C) concentrations, LDL-C, and triglycerides (TG) were significantly reduced in the population sample by (14%, 5%, 30%), respectively. The response were significant after 3 months for C (-16%), LDL-C (-0,1%) and NHDL-C (-19%), after 6 months for C (-13%), TG (-30%), LDL-C (-9%), NHDL-C (-17%), Castelli I (-14%) and Castelli II (-4%) and, after 12 months for C (-14%), TG (-27%) and Castelli I (-13%). No change was detected in plasma HDL-cholesterol and body weight, after nutritional counseling. Between sexes plasma concentrations reduced for C and TG by 16%, and 36% in men, and by 12% and 26% and 12% for LDL-C in women, and between age by 15% to C, 2% to LDL-C and 33% to TG in middle age and, 14% for C in elderly people. HDL cholesterol concentration was significantly higher in men than in women with mixed hyperlipidemia (+5% and -4 %). All participants responded to nutritional counseling reducing C, TG, LDL-C, NHDL-C, LDL-C. The nutritional counseling time did not modify the responses of plasma lipids and lipoproteins. After 3 months, beneficial effects of the diet were observed, and the higher number of parameters were reduced after 6 month showing a broader actions of diet. Men and adults patients presented better responses to nutritional counseling. The responses to nutritional counseling were higher than coefficient biology variation for each parameter evaluated except to LDL-C. We recommend this positive experience is recommended to other Health Service because is low cost treatment and also contribute in prevention and control of risk factors for cardiovascular disease / Mestrado / Ciencias Basicas / Mestre em Clinica Medica

L’hypoglycémie est une barrière au traitement du diabète de type 1 (DbT1). La collation au coucher est recommandée pour prévenir l’hypoglycémie nocturne (HN), mais son efficacité n’est pas démontrée. Objectif : Déterminer si une prise alimentaire en soirée est associée à la survenue d’HN. Étude observationnelle : 100 DbT1 ont porté un lecteur de glucose en continu et complété un journal alimentaire pendant 72 heures. L’HN est survenue durant 28 % des nuits. Une prise alimentaire en soirée n’était pas associée à l’HN. Toutefois, dans un modèle ajusté, l’apport en glucides en soirée était positivement associé aux HN (avec injection d’insuline rapide) et l’apport en protéines inversement associé aux HN (sans injection d’insuline rapide). Manger en soirée ne semble pas associé à moins d’HN. Des études contrôlées sont nécessaires pour comprendre l’effet de la collation au coucher sur le contrôle glycémique et le rôle de l’insuline rapide injectée en soirée. / Hypoglycemia remains a limiting factor of type 1 diabetes (T1D) treatment. Bedtime snack is often suggested to reduce nocturnal hypoglycemia (NH), but its effectiveness is not supported by evidence-based data. Objective: To determine the association between post-dinner dietary intake and NH occurrence. This is an observational study during which 100 T1D wore a blinded continuous glucose monitoring system and completed a food diary for 72 hours. NH occurred on 28 % of the 282 nights studied. Post-dinner dietary intake was not associated with NH. However, in multivariate models, carbohydrate intake was positively associated with NH (when rapid insulin was injected) and protein intake was inversely associated with NH (without rapid insulin injected). Post-dinner dietary intake does not seem to be associated with a reduce occurrence of NH. Further studies are needed to better understand the impact of bedtime snack on glycemic control and the role of the injection of rapid insulin in the evening.