{"paper_id":"33c50bf1-b37b-4a0b-9eb5-18f5051e0e1f","body_text":"The Association Between Caffeine Intake And Glycemic Control Among Adolescents With Type 1 Diabetes Mellitus | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Association Between Caffeine Intake And Glycemic Control Among Adolescents With Type 1 Diabetes Mellitus Fatima Al-Smadi, Nemeh Alakour, Yousef Khader This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3260865/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract AIM: The present study aimed to examine the association between caffeine intake and glycemic control as measured by HbA1c levels among adolescents with type 1 diabetes mellitus. METHOD: A cross-sectional study of eligible 96 adolescents aged between 13 to 18 years old with type 1 diabetes mellitus from three governmental hospitals and one university hospital in Jordan. Descriptive analysis was done to describe sample characteristics as well as using correlation to find the relationship between caffeine intake and glycemic control. RESULTS: The mean age of adolescents was 14.7 years old. 95.8% used the subcutaneous insulin injection method and only 4.2% used an insulin pump. 84.4% of adolescents were diagnosed with type 1 diabetes mellitus for more than one year. The mean HbA1c level was 9.3%. Study results showed that the mean daily caffeine intake was 286.7 mg which was associated with glycemic control as measured by HbA1c level. CONCLUSION: Modifying the amount of daily caffeine intake may be a proper target to get better glycemic control, especially among adolescents with type 1 diabetes mellitus. Health sciences/Health care/Nutrition Health sciences/Health care/Paediatrics Health sciences/Diseases/Endocrine system and metabolic diseases/Diabetes/Type 1 diabetes INTRODUCTION Type 1 diabetes mellitus (T1DM) is a combination of metabolic events associated with hyperglycemia and caused mostly by an autoimmune inflammatory mechanism that leads to the destruction of pancreatic β-cells and hence absolute insulin deficiency ( 1 ). The incidence of type 1 diabetes mellitus among children and adolescents around the world is increasing every year and it is approximately around a 3% annual increase ( 2 ). Approximately, according to the International Diabetes Federation (IDF) global estimates (2019), 1.1 million children and adolescents aged below 20 years old have type 1 diabetes mellitus throughout the world as well as the number of cases that are newly diagnosed every year is 128 900 cases ( 2 ). Jordan is one of the Middle East developed countries with scarce resources ( 3 ). So, there are no other available statistics had been found in the literature and Jordanian statistics about the number of adolescents with T1DM in Jordan. Adolescents with T1DM should have an appropriate target glycemic control indicator ( 4 ). One of the indicators of glycemic control is hemoglobin A1c (HbA1c), which provides an average measure over 2–3 months of glycemic status for diabetic patients ( 5 ). Good metabolic control as indicated by HbA1c level below 7.5% was achieved only by 20.9% of Jordanian children and adolescents below 18 years old ( 3 ). Recently, only 17% of adolescents with T1DM under the age of 18 years old were able to achieve the recommended glycemic target according to a large American study ( 6 ), despite the American Diabetic Association’s recommendation that glycemic control indicated by HbA1c levels should be below 7.5% for adolescents with T1DM ( 4 ). Moreover, adolescents between the ages of 15 and 18 years old have the highest level of HbA1c among the age groups which is approximately 9.3% ( 6 ). To achieve fewer complications of T1DM and appropriate HbA1c levels should be done through intensive diabetes management across all lifestyle matters ( 7 ). One of the lifestyle matters is higher caffeine intake, which is considered a common phenomenon among adolescents, could have negative outcomes on sleep and hence may lead to higher levels of HbA1c ( 8 ). The American Academy of Pediatrics recommended that adolescents aged between 12 and 18 years old consume no more than 100 mg of caffeine daily ( 9 ). But Portuguese adolescents aged between 12 and 18 years old consumed in their beverages approximately 4.2 ± 1.3 cups of caffeine a day ( 10 ). Consumption of coffee but not drinks with caffeine could have benefits on insulin levels and improve the resistance of insulin ( 11 ). A study that examined the effect of caffeine consumption on the occurrence of pre-diabetes and type 2 diabetes mellitus (T2DM) revealed a favorable effect in the prevention of pre-diabetes as well as a modification and decrease in the risk of insulin resistance ( 11 ). The duration of diabetes was negatively associated with coffee consumption as well as coffee intake was less among female patients ( 12 ). Despite the daily intake of caffeine among young American adults aged between 18 and 25 years old with T1DM was 265.28 mg daily, caffeine intake wasn’t significantly correlated with HbA1c as glycemic control ( 13 ). However, no studies to date have quantified the amount of caffeine consumption in mg and assessed its potential effect on glycemic control as measured by HbA1c level in a group of adolescents with T1DM aged between 13 to 18 years old. The current study aimed to examine the relationship between caffeine intake and HbA1c levels among adolescents with T1DM. So, the present study has the potential to develop strategies and guidelines to increase the awareness of healthcare providers and adolescents with T1DM for improving some of the modifiable lifestyle factors to get appropriate results of glycemic control. PATIENTS AND METHOD This study was a cross-sectional study that was conducted among 96 adolescents with T1DM aged between 13 to 18 years old, who attended four major Jordanian hospitals between the 18 th of May and the 18 th of October 2021. Ethical approval was obtained from the Institutional Review Board (IRB) from Jordan University Of Science And Technology (Ref No. 13/139/2021) as well approval was obtained from the ethics committee of selected hospitals. Written informed consent was signed before administering the questionnaire. The parents and their adolescents were informed that their participation was voluntary and they had the right to withdraw from the study at any time without any consequences. The participants were assured that their responses kept confidential and the codes would be assigned to the questionnaire instead of names or any information that could lead to them. The patients who were selected using a convenience, non-probability sampling method were evaluated for their eligibility to participate in this study. Inclusion criteria were patients aged between 13 to 18 years old diagnosed with T1DM for at least one year. Also, the last reading of HbA1c level maximum of 3 months was taken from the participant’s medical file. Any patient who had diabetic ketoacidosis, retinopathy, nephropathy and any of T1DM complications was excluded from the study. In addition, patients with neurological disorders and using anticonvulsant medications were excluded. The adolescent Sleep, Caffeine Intake and Technology Use (ASCT) questionnaire was self-administered questionnaire (13,14). The socio-demographical data including age, gender whether male or female, method of insulin administration whether subcutaneous injection or using an insulin pump and the number of years diagnosed with T1DM whether one year or more than one year in addition to the last HbA1c level during 3 months from the medical files of the patients. The instrument was originally designed for adolescents in a previous study (14) and then used in another study, with permission, for early young adults with some modifications (13). To use the instrument in the current study, approval was obtained from the authors. A back translation method was conducted to ensure the original (English) and the second language (Arabic) version of the instrument were measured with the same concepts. The face validity and content validity of the translated version of the instrument were checked and evaluated by two panels of experts. The expert reviewed the items for clarity, relevance, comprehensiveness, understandability and ease of administration. The content validity index (CVI) of items of the instrument was 0.84 as calculated. According to Davis, (1992) recommendation for the content validity index, is at least 0.80 to be accepted by two experts (15). The result of the pilot study showed that reliability using Cronbach's alpha for items was 0.71. The participants were asked to answer the questions in the instrument related to their caffeine intake. Caffeinated beverages including hot tea (black), coffee (brewed), cappuccino or latte, iced coffee, Starbucks refreshers, Coca-Cola, Pepsi, red bull and Power Hoarse were measured operationally by counting the daily amount of milligrams (mg) of caffeine contents in each beverage as a daily total caffeine intake (13). The caffeine content of a small cup 237 ml of brewed coffee is 95 mg of caffeine (16), while black tea has 47 mg of caffeine (17), cappuccino or latte has 80 mg of caffeine (18), iced coffee has 106 mg of caffeine (19), Starbucks refreshers have 22.5 mg of caffeine (20), Coca-Cola has 22.7 mg of caffeine while Pepsi has 25.3 mg of caffeine (21,22), Red-Bull and power horse have 76 mg of caffeine (23,24). The glycemic control indicator was measured according to the level of HbA1c that was determined by each sitting of the data collected. According to Cohen (1992), the power of analysis was determined to be 0.8, using medium effect size and the level of significant alpha to be 0.05 and the sample size was calculated to be 91 participants (25). An extra sample was determined for possible attrition was 9 participants but the available extra participants were 4 participants. The current study has an actual sample composed of 96 adolescents with T1DM. Descriptive statistics were used to characterize caffeine intake variable, demographical variables and glycemic control variable. Pearson correlation coefficients were used to evaluate the association between caffeine intake and HbA1c level. All analyses were conducted using SPSS version 23 using α ( P -value) of less than 0.05 to consider the relationship is significant. RESULTS Out of the 190 participants who were eligible to have participated in the study during the data collection period in selected hospitals, 96 participants of adolescents with T1DM completed the questionnaires and their parents accepted to participate in the study. The response rate was 51% for the study. Sample Characteristics Socio-Demographical Characteristics Ninety-six adolescents (62 girls and 34 boys) with T1DM participated in the current study. The mean age of the study participants was 14.7 ±1.7 years old with a range of 13 to 18 years old. The age was divided into three age groups, the first age group was 13 to 14 years (n= 56, 58.3%), the second group was 15 to 17 years (n= 28, 29.2%) and the third group was 18 years old (n= 12, 12.5%). Sixty-two of the participants (64.6%) were females, while the rest were males (n= 34, 35.4%). The majority of the participants used a subcutaneous insulin injection method (n= 92, 95.8%) while only four participants (4.2%) used an insulin pump to deliver the insulin. Eighty-one participants (84.4%) were diagnosed with T1DM for more than one year and the rest of the participants were diagnosed just before at least one year (n= 15, 15.6%). The mean HbA1c level among participants was 9.3% ±2.3%. A little number of participants achieved glycemic control below 7.5% (n= 18, 18.8%). Ninety-one participants (94.8%) had above-normal levels of HbA1c. While only five participants (5.2%) had normal levels of HbA1c. Table 1. shows the sociodemographic characteristics of participants. Caffeine Intake Characteristics The participants reported their intake of caffeine by determining the consumed amount of servings of the selected beverages and then counting the daily caffeine contents in each beverage to obtain the daily amount of caffeine in mg. Ninety-one participants (94.8%) reported drinking beverages that contained caffeine. The mean overall caffeine intake among participants was 286.7 ±272.7 mg. Only twenty-four of them (25%) consumed less than 100 mg of caffeine every day. The most commonly consumed caffeine-containing beverage among participants was hot tea (black) (n= 74, 77.1%) and the mean daily caffeine intake in this type of beverage was 103 ±100.3 mg, then the second beverage was Coca-Cola (n= 41, 42.7%) and the mean daily caffeine intake from Coca-Cola was 15.1 ±20 mg, followed by Pepsi (n= 38, 39.6%) and the mean caffeine intake from Pepsi was 16 ±25.8 mg, then cappuccino (latte) beverage (n= 32, 33.3%) and the mean caffeine intake from latte was 55.4 ±97.5 mg, followed by coffee (brewed) (n= 24, 25%) and the daily caffeine intake from it was 73.6 ±163.2 mg, then the Starbucks refreshers and Redbull beverages in the same percentage (n= 8, 8.3%), in which the mean daily caffeine intake from Starbucks refreshers was 3.3 ±11.8 mg while caffeine intake from Redbull beverage was 11.1 ±39.7 mg, followed by Iced coffee and Power Hoarse in the same percentage (n= 3, 3.1%), in which the mean daily caffeine intake from Iced coffee was 4.4 ±26.3 mg while caffeine intake from Power hoarse beverage was 4.8 ±28.2 mg. Table 2. presents a summary of caffeine-contained beverage consumption among participants. Table 1. The Sociodemographic Characteristics Of Participants (N=96). Characteristics Frequency Percentage (%) Age groups (years) 56 58.3% 13 – 14 15 – 17 28 29.2% = 18 12 12.5% Total 96 100% Gender 62 64.6% Females Males 34 35.4% Total 96 100% Insulin administration method 92 95.8% Subcutaneous insulin injection Insulin pump 4 4.2% Total 96 100% Years of diagnosis 15 15.6% One year More than one year 81 84.4% Total 96 100% HbA1c (glycemic control) level 91 94.8% Abnormal Normal 5 5.2% Total 96 100% Fifty-seven participants (59.4%) consumed a drink with caffeine during the school day to stay awake. The most preferred time to drink a beverage with caffeine on a normal day was on (noon-2) pm (n= 43, 44.8%), the second time on (9-11) am (n= 32, 33.3%), followed at (3-5) pm (n= 27, 28.1%), then on (6-8) pm (n= 26, 27.1%), then on (6-8) am (n= 23, 24%). Finally, only four participants (4.2%) preferred (midnight-2) am and one participant (1%) preferred (3-5) am. Table 3. summarizes the preferred times to drink a beverage with caffeine on a normal day. Caffeine Intake And Glycemic Control Pearson correlation coefficient (Pearson’s r ) was used to determine whether significant relationships existed between caffeine intake and glycemic control levels. The caffeine intake was found to have a weak positive significant relationship with HbA1c level ( r = 0.35, p = 0.001 ). This significant relationship means that as increased caffeine intake from beverages-contained caffeine among adolescents with T1DM, the HbA1c level would be increased. Table 2 . Summary Of Caffeine-Contained Beverage Consumption Among Adolescents With Type 1 Diabetes Mellitus In Jordan (N= 96). Beverage Caffeine Contents¹ Frequency, (%)² Mean (SD)³ Hot tea (black) 47 mg 74 (77.1%) 103 ±100.3 mg Coffee (brewed) 95 mg 24 (25%) 73.6 ±163.2 mg Cappuccino (latte) 80 mg 32 (33.3%) 55.4 ±97.5 mg Iced coffee 106 mg 3 (3.1%) 4.4 ±26.3 mg Starbucks refreshers 22.5 mg 8 (8.3%) 3.3 ±11.8 mg Coca-cola 22.7 mg 41 (42.7%) 15.1 ±20 mg Pepsi 25.3 mg 38 (39.6%) 16 ±25.8 mg Redbull 76 mg 8 (8.3%) 11.1 ±39.7 mg Power hoarse 76 mg 3 (3.1%) 4.8 ±28.2 mg ¹ Caffeine contents in milligrams of 237 ml for each beverage as mentioned previously. ² Number of participants drinking each beverage and their percentage. ³ Mean caffeine intake in milligrams and standard deviation. Table 3 . The Preferred Times to Drink a Beverage With Caffeine on a Normal Day. Times Number of participants Percentage (%) (noon-2) pm 43 44.8% (9-11) am 32 33.3% (3-5) pm 27 28.1% (6-8) pm 26 27.1% (6-8) am 23 24% (midnight-2) am 4 4.2% (3-5) am 1 1% DISCUSSION T1DM is a growing condition globally that affects children and adolescents ( 26 ). Our study attempted to examine the relationship between caffeine intake and glycemic control among adolescents with T1DM. To our knowledge, there is no reliable data about this issue among Jordanian adolescents with T1DM. According to our study, novel results were found that the findings indicated that daily caffeine intake was related to glycemic control among Jordanian adolescents with T1DM. In this study, the mean age of adolescents with T1DM was 14.7 ± 1.7 years old ranging from 13 to 18 years old. This finding wasn’t corroborated by many studies. In which, the mean age of adolescents with T1DM was 15.1 ± 1.3 years, 16.5 ± 1.8 years and 13.2 ± 2.2 years old, respectively ( 8 , 27 , 28 ). In our study, more than half of the participants were females (n = 62, 64.6%). This finding is consistent with the findings of previous studies which reported that 52.3% and 51.2% of total adolescents were females, respectively ( 8 , 28 ). On the other hand, other studies found that males were more than females with T1DM ( 29 , 30 ). Our study found that a subcutaneous insulin injection method was used more than an insulin pump among adolescents with T1DM. This finding is consistent with a multi-center study in Germany which reported that insulin pump usage was less than insulin injection ( 27 ). One explanation for the result might be related to financial factors in countries, in which the participants were from different provinces and villages. However, our findings weren’t corroborated by Frye et al. (2019) and Patel et al. (2019) who found that insulin pump usage among adolescents with T1DM was more than multiple-dose insulin injections ( 8 , 31 ). There were many studies had found that the duration of diabetes was more than one year as the current study among adolescents with T1DM ( 8 , 27 , 28 , 30 , 32 , 33 ). According to the American Diabetic Association, the glycemic control indicated by HbA1c level should be below 7.5% for adolescents with T1DM ( 4 ). The different findings of the current study were found that contradict the recommendation of the American Diabetic Association. In which, the mean HbA1c level in this study among adolescents with T1DM was (9.3 ± 2.3)%. The findings of this study are congruent with the results of a large landmark study that was conducted on patients with T1DM aged between 1 and 93 years old in the United States and found that the level of HbA1c among participated adolescents with T1DM was 9.3% ( 6 ). Moreover, our current study showed that most adolescents had above-normal levels of HbA1c, as well as only 18.8% of adolescents, achieved a glycemic control (HbA1c) below 7.5%. These findings were corroborated by a Jordanian study that emphasized the result of our study, which reported that only 20.9% of adolescents with T1DM achieved good glycemic control below 7.5% ( 3 ). Most of the adolescents with T1DM in this current study consumed beverages that contained caffeine 94.8%. The study by Calamaro and colleagues was consistent with our study result, in which 85% of the adolescents consumed caffeine daily ( 14 ). Caffeine intake among adolescents in the current study was approximately 286.7 mg daily. This finding is consistent with the finding of the previous study which reported that college students with T1DM had approximately a daily caffeine intake of 265.3 mg ( 13 ). In contrast, among healthy adolescents aged 16 to 18 years old in the Polish population, the intake of caffeine during the day was approximately 95.5 mg per day ( 34 ). Despite the recommendation of the American Academy of Pediatrics for adolescents to take up to 100 mg per day of caffeine or less ( 9 ), only a few adolescents in this study consumed less than 100 mg of caffeine every day. In which, out of 96 adolescents, only 24 of them were taken less than 100 mg of caffeine daily. Bebenek et al. (2021) demonstrated a congruent result to the current study, in which the most caffeinated beverage among adolescents was black tea ( 34 ). Bebenek et al. (2021) reported that the daily intake of caffeine from black tea was 25.7 ± 40.1 mg while the amount of caffeine in the current study was higher and was 103 ± 100.3 mg ( 34 ). The daily caffeine contents from the energy drinks in the current study were from Red Bull and Power Hoarse products. Findings of the healthy adolescent study reported that the daily caffeine intake from energy drinks was approximately 12.7 mg ( 34 ), which is similar to the current study that found caffeine contents from Red Bull were 11.1 mg and Power Hoarse were 4.8 mg. So, on average the total intake of caffeine among adolescents with T1DM in the current study was 15.9 mg. The presented study found that caffeine intake from Coca-cola was 15.1 ± 20 mg among adolescents while according to Bebenek et al. (2021) found that consumption of caffeine was 10.72 ± 21.55 mg from Cola. Regarding caffeine intake from coffee in the current study was 73.6 mg daily whereas according to another American study was conducted by Drewnowski and Rehm (2016) found that the caffeine intake from coffee among adolescents aged between 14 and 19 years old was 15 mg daily ( 35 ). The findings of the current study showed that daily caffeine intake from Cappuccino and Pepsi was 55.4 mg and 16 mg, respectively. A previous study showed a higher intake of caffeine in comparison with the current study among adolescents from Cappuccino and Pepsi, which were 72.5 mg and 38.04 mg daily, respectively ( 14 ). Calamaro and her colleagues in their study found that adolescents consumed beverages with caffeine before or after school times ( 14 ), which was similar to some adolescents in the current study. The presented study found that caffeine intake had a positive association with HbA1c levels among adolescents, in which higher caffeine intake was associated with an increase in HbA1c levels. The finding of this study wasn’t congruent with the result of the Iranian study which reported that consumption of drinks with caffeine and coffee decreased the risk of occurrence of type 2 diabetes mellitus and pre-diabetes among adults ( 11 ). Moreover, another study was inconsistent with our study result which found that no relationship between caffeine intake and HbA1c levels among adults with T1DM ( 13 ). Elnour et al. (2019) found no relationship among glycemic control and coffee consumption among adults with type 2 diabetes mellitus in Tabuk City in Saudi Arabia ( 12 ). Furthermore, a comprehensive meta-analysis found incongruent results with our study results ( 36 ). In which, one of the included studies demonstrated no relationship between caffeine intake and blood glucose levels among adults with T1DM ( 36 ). The previous analysis found in other included studies that hypoglycemia episodes raised among adults with T1DM who consumed daily caffeine ( 36 ). To our best knowledge, daily caffeine intake and its relationship with glycemic control has scarcely been explored in adolescents with T1DM worldwide and especially in Jordan and this is the first study that discussed this issue. CONCLUSION In summary, to our best knowledge, this is the first study to comprehensively examine the relationship among caffeine intake, and glycemic control among Jordanian adolescents with T1DM. So, the worse glycemic control is related to increase caffeine intake. The study could contribute to increase knowledge and awareness among adolescents with T1DM and health care providers at hospitals as well as diverse educators toward predictors of poor glycemic control among adolescents with T1DM. Therefore, replication of the study is recommended with a large sample size and experimental studies are recommended to incorporate the role of the current findings in diabetes counseling and management as well as to be able to generalize these findings. In addition, replication of the study is recommended on other populations such as younger children and adults with T1DM to examine the possibility of generalization of findings. Moreover, longitudinal and qualitative studies are recommended to explore the role of daily caffeine with its impact on glycemic control on T1DM. Declarations COMPETING INTERESTS The authors declare no competing interests. AUTHOR CONTRIBUTIONS FYA was responsible for the literature search, study design, data collection, and statistical analysis with the interpretation of the data as well as FYA was responsible for writing the discussion of the study. NAA provided supervision and mentorship from the first preparation to the final version. YSK provided feedback on the study and checked the statistical analysis and results. All authors collaborated in the preparation and writing of the manuscript, revision, and ensuring the integrity of manuscript parts. Also, all authors had full access to all the data, verified the accuracy of all underlying data, and had final responsibility for the decision to submit for publication. ACKNOWLEDGMENTS The authors thank all the adolescents and their parents who agreed to participate in this study as well as the Jordan University Of Science and Technology, all of the hospitals, and the people where the data collection was done. 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Diabetes Metab Syndr Clin Res Rev [Internet]. ; Available from: http://dx.doi.org/10.1016/j.dsx.2017.04.017 Additional Declarations There is NO conflict of interest to disclose Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-3260865\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Article\",\"associatedPublications\":[],\"authors\":[{\"id\":226819766,\"identity\":\"69bcfd87-2443-4236-bd76-3013d459487c\",\"order_by\":0,\"name\":\"Fatima Al-Smadi\",\"email\":\"data:image/png;base64,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\",\"orcid\":\"\",\"institution\":\"Jordan University of Science and Technology\",\"correspondingAuthor\":true,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Fatima\",\"middleName\":\"\",\"lastName\":\"Al-Smadi\",\"suffix\":\"\"},{\"id\":226819767,\"identity\":\"b827dd14-1d50-4876-ac9e-56c7af175b73\",\"order_by\":1,\"name\":\"Nemeh Alakour\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Jordan University of Science and Technology\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Nemeh\",\"middleName\":\"\",\"lastName\":\"Alakour\",\"suffix\":\"\"},{\"id\":226819768,\"identity\":\"4d96225c-c5c3-477b-9916-3c9c5a58d4f6\",\"order_by\":2,\"name\":\"Yousef Khader\",\"email\":\"\",\"orcid\":\"https://orcid.org/0000-0002-7830-6857\",\"institution\":\"JORDAN UNIVERSITY OF SCIENCE AND TECHNOLOGY\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Yousef\",\"middleName\":\"\",\"lastName\":\"Khader\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2023-08-13 23:50:39\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-3260865/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-3260865/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":45463347,\"identity\":\"47d5211a-b210-44f5-9e7f-2048755d938e\",\"added_by\":\"auto\",\"created_at\":\"2023-10-30 16:49:25\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":379412,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3260865/v1/51156862-41a0-4f00-a367-6665e818c5ae.pdf\"}],\"financialInterests\":\"There is \\u003cb\\u003eNO\\u003c/b\\u003e conflict of interest to disclose\",\"formattedTitle\":\"The Association Between Caffeine Intake And Glycemic Control Among Adolescents With Type 1 Diabetes Mellitus\",\"fulltext\":[{\"header\":\"INTRODUCTION\",\"content\":\"\\u003cp\\u003eType 1 diabetes mellitus (T1DM) is a combination of metabolic events associated with hyperglycemia and caused mostly by an autoimmune inflammatory mechanism that leads to the destruction of pancreatic β-cells and hence absolute insulin deficiency (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e). The incidence of type 1 diabetes mellitus among children and adolescents around the world is increasing every year and it is approximately around a 3% annual increase (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). Approximately, according to the International Diabetes Federation (IDF) global estimates (2019), 1.1\\u0026nbsp;million children and adolescents aged below 20 years old have type 1 diabetes mellitus throughout the world as well as the number of cases that are newly diagnosed every year is 128 900 cases (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). Jordan is one of the Middle East developed countries with scarce resources (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e). So, there are no other available statistics had been found in the literature and Jordanian statistics about the number of adolescents with T1DM in Jordan. Adolescents with T1DM should have an appropriate target glycemic control indicator (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). One of the indicators of glycemic control is hemoglobin A1c (HbA1c), which provides an average measure over 2–3 months of glycemic status for diabetic patients (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e). Good metabolic control as indicated by HbA1c level below 7.5% was achieved only by 20.9% of Jordanian children and adolescents below 18 years old (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e). Recently, only 17% of adolescents with T1DM under the age of 18 years old were able to achieve the recommended glycemic target according to a large American study (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e), despite the American Diabetic Association’s recommendation that glycemic control indicated by HbA1c levels should be below 7.5% for adolescents with T1DM (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). Moreover, adolescents between the ages of 15 and 18 years old have the highest level of HbA1c among the age groups which is approximately 9.3% (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e). To achieve fewer complications of T1DM and appropriate HbA1c levels should be done through intensive diabetes management across all lifestyle matters (\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e). One of the lifestyle matters is higher caffeine intake, which is considered a common phenomenon among adolescents, could have negative outcomes on sleep and hence may lead to higher levels of HbA1c (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e). The American Academy of Pediatrics recommended that adolescents aged between 12 and 18 years old consume no more than 100 mg of caffeine daily (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e). But Portuguese adolescents aged between 12 and 18 years old consumed in their beverages approximately 4.2 ± 1.3 cups of caffeine a day (\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eConsumption of coffee but not drinks with caffeine could have benefits on insulin levels and improve the resistance of insulin (\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e). A study that examined the effect of caffeine consumption on the occurrence of pre-diabetes and type 2 diabetes mellitus (T2DM) revealed a favorable effect in the prevention of pre-diabetes as well as a modification and decrease in the risk of insulin resistance (\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e). The duration of diabetes was negatively associated with coffee consumption as well as coffee intake was less among female patients (\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e). Despite the daily intake of caffeine among young American adults aged between 18 and 25 years old with T1DM was 265.28 mg daily, caffeine intake wasn’t significantly correlated with HbA1c as glycemic control (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eHowever, no studies to date have quantified the amount of caffeine consumption in mg and assessed its potential effect on glycemic control as measured by HbA1c level in a group of adolescents with T1DM aged between 13 to 18 years old. The current study aimed to examine the relationship between caffeine intake and HbA1c levels among adolescents with T1DM. So, the present study has the potential to develop strategies and guidelines to increase the awareness of healthcare providers and adolescents with T1DM for improving some of the modifiable lifestyle factors to get appropriate results of glycemic control.\\u003c/p\\u003e \\u003cp\\u003e\\u003c/p\\u003e \"},{\"header\":\"PATIENTS AND METHOD\",\"content\":\"\\u003cp\\u003eThis study was a cross-sectional study that was conducted among 96 adolescents with T1DM aged between 13 to 18 years old, who attended four major Jordanian hospitals between the 18\\u003csup\\u003eth\\u003c/sup\\u003e of May and the 18\\u003csup\\u003eth\\u003c/sup\\u003e of October 2021.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eEthical approval was obtained from the Institutional Review Board (IRB) from Jordan University Of Science And Technology (Ref No. 13/139/2021) as well approval was obtained from the ethics committee of selected hospitals. Written informed consent was signed before administering the questionnaire. The parents and their adolescents were informed that their participation was voluntary and they had the right to withdraw from the study at any time without any consequences. The participants were assured that their responses kept confidential and the codes would be assigned to the questionnaire instead of names or any information that could lead to them.\\u003c/p\\u003e\\n\\u003cp\\u003eThe patients who were selected using a convenience, non-probability sampling method were evaluated for their eligibility to participate in this study. Inclusion criteria were patients aged between 13 to 18 years old diagnosed with T1DM for at least one year. Also, the last reading of HbA1c level maximum of 3 months was taken from the participant\\u0026rsquo;s medical file. Any patient who had diabetic ketoacidosis, retinopathy, nephropathy and any of T1DM complications was excluded from the study. In addition, patients with neurological disorders and using anticonvulsant medications were excluded.\\u003c/p\\u003e\\n\\u003cp\\u003eThe adolescent Sleep, Caffeine Intake and Technology Use (ASCT) questionnaire was self-administered questionnaire\\u0026nbsp;(13,14). The socio-demographical data including age, gender whether male or female, method of insulin administration whether subcutaneous injection or using an insulin pump and the number of years diagnosed with T1DM whether one year or more than one year in addition to the last HbA1c level during 3 months from the medical files of the patients.\\u003c/p\\u003e\\n\\u003cp\\u003eThe instrument was originally designed for adolescents in a previous study\\u0026nbsp;(14)\\u0026nbsp;and then used in another study, with permission, for early young adults with some modifications\\u0026nbsp;(13). To use the instrument in the current study, approval was obtained from the authors. A back translation method was conducted to ensure the original (English) and the second language (Arabic) version of the instrument were measured with the same concepts. The face validity and content validity of the translated version of the instrument were checked and evaluated by two panels of experts. The expert reviewed the items for clarity, relevance, comprehensiveness, understandability and ease of administration. The content validity index (CVI) of items of the instrument was 0.84 as calculated. According to Davis, (1992) recommendation for the content validity index, is at least 0.80 to be accepted by two experts\\u0026nbsp;(15). The result of the pilot study showed that reliability using Cronbach\\u0026apos;s alpha for items was 0.71.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eThe participants were asked to answer the questions in the instrument related to their caffeine intake. Caffeinated beverages including hot tea (black), coffee (brewed), cappuccino or latte, iced coffee, Starbucks refreshers, Coca-Cola, Pepsi, red bull and Power Hoarse were measured operationally by counting the daily amount of milligrams (mg) of caffeine contents in each beverage as a daily total caffeine intake\\u0026nbsp;(13). The caffeine content of a small cup 237 ml of brewed coffee is 95 mg of caffeine\\u0026nbsp;(16), while black tea has 47 mg of caffeine\\u0026nbsp;(17), cappuccino or latte has 80 mg of caffeine\\u0026nbsp;(18), iced coffee has 106 mg of caffeine\\u0026nbsp;(19), Starbucks refreshers have 22.5 mg of caffeine\\u0026nbsp;(20), Coca-Cola has 22.7 mg of caffeine while Pepsi has 25.3 mg of caffeine\\u0026nbsp;(21,22), Red-Bull and power horse have 76 mg of caffeine\\u0026nbsp;(23,24). The glycemic control indicator was measured according to the level of HbA1c that was determined by each sitting of the data collected.\\u003c/p\\u003e\\n\\u003cp\\u003eAccording to Cohen (1992), the power of analysis was determined to be 0.8, using medium effect size and the level of significant alpha to be 0.05 and the sample size was calculated to be 91 participants\\u0026nbsp;(25). An extra sample was determined for possible attrition was 9 participants but the available extra participants were 4 participants. The current study has an actual sample composed of 96 adolescents with T1DM. Descriptive statistics were used to characterize caffeine intake variable, demographical variables and glycemic control variable. Pearson correlation coefficients were used to evaluate the association between caffeine intake and HbA1c level. All analyses were conducted using SPSS version 23 using \\u0026alpha; (\\u003cem\\u003eP\\u003c/em\\u003e-value) of less than 0.05 to consider the relationship is significant.\\u003c/p\\u003e\"},{\"header\":\"RESULTS\",\"content\":\"\\u003cp\\u003eOut of the 190 participants who were eligible to have participated in the study during the data collection period in selected hospitals, 96 participants of adolescents with T1DM completed the questionnaires and their parents accepted to participate in the study. The response rate was 51% for the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eSample Characteristics\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eSocio-Demographical Characteristics\\u0026nbsp;\\u003c/strong\\u003eNinety-six adolescents (62 girls and 34 boys) with T1DM participated in the current study. The mean age of the study participants was 14.7 \\u0026plusmn;1.7 years old with a range of 13 to 18 years old. The age was divided into three age groups, the first age group was 13 to 14 years (n= 56, 58.3%), the second group was 15 to 17 years (n= 28, 29.2%) and the third group was 18 years old (n= 12, 12.5%). Sixty-two of the participants (64.6%) were females, while the rest were males (n= 34, 35.4%). The majority of the participants used a subcutaneous insulin injection method (n= 92, 95.8%) while only four participants (4.2%) used an insulin pump to deliver the insulin. Eighty-one participants (84.4%) were diagnosed with T1DM for more than one year and the rest of the participants were diagnosed just before at least one year (n= 15, 15.6%). The mean HbA1c level among participants was 9.3% \\u0026plusmn;2.3%. A little number of participants achieved glycemic control below 7.5% (n= 18, 18.8%). Ninety-one participants (94.8%) had above-normal levels of HbA1c. While only five participants (5.2%) had normal levels of HbA1c. Table 1. shows the sociodemographic characteristics of participants.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCaffeine Intake Characteristics\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe participants reported their intake of caffeine by determining the consumed amount of servings of the selected beverages and then counting the daily caffeine contents in each beverage to obtain the daily amount of caffeine in mg.\\u003c/p\\u003e\\n\\u003cp\\u003eNinety-one participants (94.8%) reported drinking beverages that contained caffeine. The mean overall caffeine intake among participants was 286.7 \\u0026plusmn;272.7 mg. Only twenty-four of them (25%) consumed less than 100 mg of caffeine every day. The most commonly consumed caffeine-containing beverage among participants was hot tea (black) (n= 74, 77.1%) and the mean daily caffeine intake in this type of beverage was 103 \\u0026plusmn;100.3 mg, then the second beverage was Coca-Cola (n= 41, 42.7%) and the mean daily caffeine intake from Coca-Cola was 15.1 \\u0026plusmn;20 mg, followed by Pepsi (n= 38, 39.6%) and the mean caffeine intake from Pepsi was 16 \\u0026plusmn;25.8 mg, then cappuccino (latte) beverage (n= 32, 33.3%) and the mean caffeine intake from latte was 55.4 \\u0026plusmn;97.5 mg, followed by coffee (brewed) (n= 24, 25%) and the daily caffeine intake from it was 73.6 \\u0026plusmn;163.2 mg, then the Starbucks refreshers and Redbull beverages in the same percentage (n= 8, 8.3%), in which the mean daily caffeine intake from Starbucks refreshers was 3.3 \\u0026plusmn;11.8 mg while caffeine intake from Redbull beverage was 11.1 \\u0026plusmn;39.7 mg, followed by Iced coffee and Power Hoarse in the same percentage (n= 3, 3.1%), in which the mean daily caffeine intake from Iced coffee was 4.4 \\u0026plusmn;26.3 mg while caffeine intake from Power hoarse beverage was 4.8 \\u0026plusmn;28.2 mg. Table 2. presents a summary of caffeine-contained beverage consumption among participants.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"width:447.7pt;border-collapse:collapse;border:none;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"3\\\" style=\\\"width:447.7pt;border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid #4F81BD 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:26.5pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;'\\u003eTable 1. The Sociodemographic Characteristics Of Participants (N=96).\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width:167.4pt;border:none;background:#D3DFEE;padding:0in 5.4pt 0in 5.4pt;height:26.5pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eCharacteristics\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:131.9pt;border:none;background:#D3DFEE;padding:0in 5.4pt 0in 5.4pt;height:26.5pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eFrequency\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:148.4pt;border:none;background:#D3DFEE;padding:0in 5.4pt 0in 5.4pt;height:26.5pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003ePercentage (%)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width:167.4pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp 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style=\\\"width:131.9pt;border:none;background:#D3DFEE;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e4\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:148.4pt;border:none;background:#D3DFEE;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e4.2%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width:167.4pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eTotal\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:131.9pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e96\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:148.4pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e100%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eYears of diagnosis\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd rowspan=\\\"2\\\" style=\\\"width: 131.9pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e15\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd rowspan=\\\"2\\\" style=\\\"width: 148.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e15.6%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;padding: 0in 5.4pt;height: 27.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eOne year\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eMore than one year\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 131.9pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e81\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 148.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e84.4%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eTotal\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 131.9pt;border: medium;padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e96\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 148.4pt;border: medium;padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e100%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eHbA1c (glycemic control) level\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd rowspan=\\\"2\\\" style=\\\"width: 131.9pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e91\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd rowspan=\\\"2\\\" style=\\\"width: 148.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e94.8%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;padding: 0in 5.4pt;height: 27.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eAbnormal\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eNormal\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 131.9pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e5\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 148.4pt;border: medium;background: rgb(211, 223, 238);padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e5.2%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 167.4pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor rgb(79, 129, 189);border-image: none;padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eTotal\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 131.9pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor rgb(79, 129, 189);border-image: none;padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e96\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 148.4pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor rgb(79, 129, 189);border-image: none;padding: 0in 5.4pt;vertical-align: bottom;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e100%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eFifty-seven participants (59.4%) consumed a drink with caffeine during the school day to stay awake. The most preferred time to drink a beverage with caffeine on a normal day was on (noon-2) pm (n= 43, 44.8%), the second time on (9-11) am (n= 32, 33.3%), followed at (3-5) pm (n= 27, 28.1%), then on (6-8) pm (n= 26, 27.1%), then on (6-8) am (n= 23, 24%). Finally, only four participants (4.2%) preferred (midnight-2) am and one participant (1%) preferred (3-5) am. Table 3. summarizes the preferred times to drink a beverage with caffeine on a normal day.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCaffeine Intake And Glycemic Control\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003ePearson correlation coefficient \\u0026nbsp; \\u0026nbsp;(Pearson\\u0026rsquo;s \\u003cem\\u003er\\u003c/em\\u003e) was used to determine whether significant relationships existed between caffeine intake and glycemic control levels. The caffeine intake was found to have a weak positive significant relationship with HbA1c level ( \\u003cem\\u003er\\u003c/em\\u003e = 0.35, \\u003cem\\u003ep\\u003c/em\\u003e = 0.001 ). This significant relationship means that as increased caffeine intake from beverages-contained caffeine among adolescents with T1DM, the HbA1c level would be increased.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"border-collapse:collapse;border:none;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"4\\\" style=\\\"width: 6.65in;border-width: 1pt medium;border-style: solid none;border-color: black currentcolor;padding: 0in 5.4pt;height: 23.55pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:4.0pt;margin-left:76.5pt;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;text-indent:-76.5pt;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eTable 2\\u003c/span\\u003e\\u003c/strong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e.\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003eSummary Of Caffeine-Contained Beverage Consumption Among \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; Adolescents With Type 1 Diabetes Mellitus In Jordan (N= 96).\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width:119.7pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;height:17.9pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eBeverage\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:119.7pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;height:17.9pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eCaffeine Contents\\u0026sup1;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:119.7pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;height:17.9pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eFrequency, (%)\\u0026sup2;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:119.7pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;height:17.9pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eMean (SD)\\u0026sup3;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 119.7pt;border: medium;padding: 0in 5.4pt;height: 9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp 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9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e8 (8.3%)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 119.7pt;border: medium;background: silver;padding: 0in 5.4pt;height: 9pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e11.1 \\u0026plusmn;39.7 mg\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 119.7pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor black;border-image: none;padding: 0in 5.4pt;height: 0.2in;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003ePower hoarse\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 119.7pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor black;border-image: none;padding: 0in 5.4pt;height: 0.2in;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e76 mg\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 119.7pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor black;border-image: none;padding: 0in 5.4pt;height: 0.2in;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e3 (3.1%)\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 119.7pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor black;border-image: none;padding: 0in 5.4pt;height: 0.2in;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e4.8 \\u0026plusmn;28.2 mg\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u003cbr\\u003e\\u003c/span\\u003e\\u003c/strong\\u003e\\u003cspan style='font-size:16px;line-height:90%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026sup1; Caffeine contents in milligrams of 237 ml for each beverage as mentioned previously.\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:4.0pt;margin-left:0in;line-height:90%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cspan style='font-size:16px;line-height:90%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026sup2; Number of participants drinking each beverage and their percentage.\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:4.0pt;margin-left:0in;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cspan style='font-size:16px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026sup3; Mean caffeine intake in milligrams and standard deviation.\\u003c/span\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cbr\\u003e\\u003c/p\\u003e\\n\\u003ctable style=\\\"border-collapse:collapse;border:none;\\\"\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd colspan=\\\"3\\\" style=\\\"width: 217.8pt;border-width: 1pt medium;border-style: solid none;border-color: black currentcolor;padding: 0in 5.4pt;height: 27.85pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: normal;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eTable 3\\u003c/span\\u003e\\u003c/strong\\u003e\\u003cspan style='font-size:16px;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e.\\u003cstrong\\u003e\\u0026nbsp;\\u003c/strong\\u003eThe Preferred Times to Drink a Beverage With Caffeine on a Normal Day.\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;background: silver;padding: 0in 5.4pt;height: 27.85pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eTimes\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 77.65pt;border: medium;background: silver;padding: 0in 5.4pt;height: 27.85pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003eNumber of participants\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width: 72.55pt;border: medium;background: silver;padding: 0in 5.4pt;height: 27.85pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003ePercentage (%)\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(noon-2) pm\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e43\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e44.8%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;background: silver;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(9-11) am\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e32\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e33.3%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(3-5) pm\\u0026nbsp;\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e27\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e28.1%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;background: silver;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(6-8) pm\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e26\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e27.1%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(6-8) am\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e23\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e24%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border: medium;background: silver;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(midnight-2) am\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e4\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;background:silver;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height: 115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e4.2%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd style=\\\"width: 67.6pt;border-width: medium medium 1pt;border-style: none none solid;border-color: currentcolor currentcolor black;border-image: none;padding: 0in 5.4pt;vertical-align: top;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height: 115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cstrong\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family:\\\"Times New Roman\\\",serif;color:black;'\\u003e(3-5) am\\u003c/span\\u003e\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:77.65pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e1\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd style=\\\"width:72.55pt;border:none;border-bottom:solid black 1.0pt;padding:0in 5.4pt 0in 5.4pt;\\\"\\u003e\\n \\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:115%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:center;'\\u003e\\u003cspan style='font-size:16px;line-height:115%;font-family: \\\"Times New Roman\\\",serif;color:black;'\\u003e1%\\u003c/span\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:200%;font-size:15px;font-family:\\\"Calibri\\\",sans-serif;text-align:justify;'\\u003e\\u003cspan style='font-size:16px;line-height:200%;font-family:\\\"Times New Roman\\\",serif;'\\u003e\\u0026nbsp;\\u003c/span\\u003e\\u003c/p\\u003e\"},{\"header\":\"DISCUSSION\",\"content\":\"\\u003cp\\u003eT1DM is a growing condition globally that affects children and adolescents (\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e). Our study attempted to examine the relationship between caffeine intake and glycemic control among adolescents with T1DM. To our knowledge, there is no reliable data about this issue among Jordanian adolescents with T1DM. According to our study, novel results were found that the findings indicated that daily caffeine intake was related to glycemic control among Jordanian adolescents with T1DM.\\u003c/p\\u003e \\u003cp\\u003eIn this study, the mean age of adolescents with T1DM was 14.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.7 years old ranging from 13 to 18 years old. This finding wasn\\u0026rsquo;t corroborated by many studies. In which, the mean age of adolescents with T1DM was 15.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.3 years, 16.5\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.8 years and 13.2\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.2 years old, respectively (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e). In our study, more than half of the participants were females (n\\u0026thinsp;=\\u0026thinsp;62, 64.6%). This finding is consistent with the findings of previous studies which reported that 52.3% and 51.2% of total adolescents were females, respectively (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e). On the other hand, other studies found that males were more than females with T1DM (\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e). Our study found that a subcutaneous insulin injection method was used more than an insulin pump among adolescents with T1DM. This finding is consistent with a multi-center study in Germany which reported that insulin pump usage was less than insulin injection (\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e). One explanation for the result might be related to financial factors in countries, in which the participants were from different provinces and villages. However, our findings weren\\u0026rsquo;t corroborated by Frye \\u003cem\\u003eet al.\\u003c/em\\u003e (2019) and Patel \\u003cem\\u003eet al.\\u003c/em\\u003e (2019) who found that insulin pump usage among adolescents with T1DM was more than multiple-dose insulin injections (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e). There were many studies had found that the duration of diabetes was more than one year as the current study among adolescents with T1DM (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e32\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e33\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eAccording to the American Diabetic Association, the glycemic control indicated by HbA1c level should be below 7.5% for adolescents with T1DM (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). The different findings of the current study were found that contradict the recommendation of the American Diabetic Association. In which, the mean HbA1c level in this study among adolescents with T1DM was (9.3\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.3)%. The findings of this study are congruent with the results of a large landmark study that was conducted on patients with T1DM aged between 1 and 93 years old in the United States and found that the level of HbA1c among participated adolescents with T1DM was 9.3% (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e). Moreover, our current study showed that most adolescents had above-normal levels of HbA1c, as well as only 18.8% of adolescents, achieved a glycemic control (HbA1c) below 7.5%. These findings were corroborated by a Jordanian study that emphasized the result of our study, which reported that only 20.9% of adolescents with T1DM achieved good glycemic control below 7.5% (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eMost of the adolescents with T1DM in this current study consumed beverages that contained caffeine 94.8%. The study by Calamaro and colleagues was consistent with our study result, in which 85% of the adolescents consumed caffeine daily (\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e). Caffeine intake among adolescents in the current study was approximately 286.7 mg daily. This finding is consistent with the finding of the previous study which reported that college students with T1DM had approximately a daily caffeine intake of 265.3 mg (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e). In contrast, among healthy adolescents aged 16 to 18 years old in the Polish population, the intake of caffeine during the day was approximately 95.5 mg per day (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eDespite the recommendation of the American Academy of Pediatrics for adolescents to take up to 100 mg per day of caffeine or less (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e), only a few adolescents in this study consumed less than 100 mg of caffeine every day. In which, out of 96 adolescents, only 24 of them were taken less than 100 mg of caffeine daily.\\u003c/p\\u003e \\u003cp\\u003eBebenek \\u003cem\\u003eet al.\\u003c/em\\u003e (2021) demonstrated a congruent result to the current study, in which the most caffeinated beverage among adolescents was black tea (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e). Bebenek \\u003cem\\u003eet al.\\u003c/em\\u003e (2021) reported that the daily intake of caffeine from black tea was 25.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;40.1 mg while the amount of caffeine in the current study was higher and was 103\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;100.3 mg (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e). The daily caffeine contents from the energy drinks in the current study were from Red Bull and Power Hoarse products. Findings of the healthy adolescent study reported that the daily caffeine intake from energy drinks was approximately 12.7 mg (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e), which is similar to the current study that found caffeine contents from Red Bull were 11.1 mg and Power Hoarse were 4.8 mg. So, on average the total intake of caffeine among adolescents with T1DM in the current study was 15.9 mg.\\u003c/p\\u003e \\u003cp\\u003eThe presented study found that caffeine intake from Coca-cola was 15.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;20 mg among adolescents while according to Bebenek \\u003cem\\u003eet al.\\u003c/em\\u003e (2021) found that consumption of caffeine was 10.72\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;21.55 mg from Cola. Regarding caffeine intake from coffee in the current study was 73.6 mg daily whereas according to another American study was conducted by Drewnowski and Rehm (2016) found that the caffeine intake from coffee among adolescents aged between 14 and 19 years old was 15 mg daily (\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eThe findings of the current study showed that daily caffeine intake from Cappuccino and Pepsi was 55.4 mg and 16 mg, respectively. A previous study showed a higher intake of caffeine in comparison with the current study among adolescents from Cappuccino and Pepsi, which were 72.5 mg and 38.04 mg daily, respectively (\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eCalamaro and her colleagues in their study found that adolescents consumed beverages with caffeine before or after school times (\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e), which was similar to some adolescents in the current study.\\u003c/p\\u003e \\u003cp\\u003eThe presented study found that caffeine intake had a positive association with HbA1c levels among adolescents, in which higher caffeine intake was associated with an increase in HbA1c levels. The finding of this study wasn\\u0026rsquo;t congruent with the result of the Iranian study which reported that consumption of drinks with caffeine and coffee decreased the risk of occurrence of type 2 diabetes mellitus and pre-diabetes among adults (\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e). Moreover, another study was inconsistent with our study result which found that no relationship between caffeine intake and HbA1c levels among adults with T1DM (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e). Elnour \\u003cem\\u003eet al.\\u003c/em\\u003e (2019) found no relationship among glycemic control and coffee consumption among adults with type 2 diabetes mellitus in Tabuk City in Saudi Arabia (\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e). Furthermore, a comprehensive meta-analysis found incongruent results with our study results (\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e). In which, one of the included studies demonstrated no relationship between caffeine intake and blood glucose levels among adults with T1DM (\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e). The previous analysis found in other included studies that hypoglycemia episodes raised among adults with T1DM who consumed daily caffeine (\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eTo our best knowledge, daily caffeine intake and its relationship with glycemic control has scarcely been explored in adolescents with T1DM worldwide and especially in Jordan and this is the first study that discussed this issue.\\u003c/p\\u003e\"},{\"header\":\"CONCLUSION\",\"content\":\"\\u003cp\\u003eIn summary, to our best knowledge, this is the first study to comprehensively examine the relationship among caffeine intake, and glycemic control among Jordanian adolescents with T1DM. So, the worse glycemic control is related to increase caffeine intake. The study could contribute to increase knowledge and awareness among adolescents with T1DM and health care providers at hospitals as well as diverse educators toward predictors of poor glycemic control among adolescents with T1DM. Therefore, replication of the study is recommended with a large sample size and experimental studies are recommended to incorporate the role of the current findings in diabetes counseling and management as well as to be able to generalize these findings. In addition, replication of the study is recommended on other populations such as younger children and adults with T1DM to examine the possibility of generalization of findings.\\u003c/p\\u003e \\u003cp\\u003eMoreover, longitudinal and qualitative studies are recommended to explore the role of daily caffeine with its impact on glycemic control on T1DM.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e \\u003ch2\\u003eCOMPETING INTERESTS\\u003c/h2\\u003e \\u003cp\\u003eThe authors declare no competing interests.\\u003c/p\\u003e \\u003c/p\\u003e\\u003ch2\\u003eAUTHOR CONTRIBUTIONS\\u003c/h2\\u003e \\u003cp\\u003eFYA was responsible for the literature search, study design, data collection, and statistical analysis with the interpretation of the data as well as FYA was responsible for writing the discussion of the study. NAA provided supervision and mentorship from the first preparation to the final version. YSK provided feedback on the study and checked the statistical analysis and results. All authors collaborated in the preparation and writing of the manuscript, revision, and ensuring the integrity of manuscript parts. Also, all authors had full access to all the data, verified the accuracy of all underlying data, and had final responsibility for the decision to submit for publication.\\u003c/p\\u003e\\u003ch2\\u003eACKNOWLEDGMENTS\\u003c/h2\\u003e \\u003cp\\u003e The authors thank all the adolescents and their parents who agreed to participate in this study as well as the Jordan University Of Science and Technology, all of the hospitals, and the people where the data collection was done.\\u003c/p\\u003e\\u003ch2\\u003eDATA AVAILABILITY\\u003c/h2\\u003e \\u003cp\\u003eResearchers can request access to the data related to study documents after publication, including the statistical analysis plan. The data will be freely available for non-commercial purposes. Patient-level data will be anonymized, and study documents will be redacted to protect the privacy of the participants.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eEgan AM (2018) What is diabetes ? Key points. ;1\\u0026ndash;4\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKaruranga S, Malanda B, Saeedi P, Salpea P (2019) Idf diabetes atlas [Internet]. 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Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1016/j.numecd.2018.09.001\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.numecd.2018.09.001\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eElnour M, Saleh A, Kalantan M, Mirghani H (2019) The relationship between coffee intake, obstructive sleep apnea risk, and type 2 diabetes glycemic control, in Tabuk City, The Kingdom of Saudi Arabia : a case \\u0026ndash; control study. BMC Res Notes [Internet]. ;1\\u0026ndash;5. 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Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1016/j.diabres.2019.01.007\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.diabres.2019.01.007\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCalamaro CJ, Mason TBA, Ratcliffe SJ (2009) \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttp://pediatrics.aappublications.org/content/123/6/e1005.full.html\\u003c/span\\u003e\\u003cspan address=\\\"http://pediatrics.aappublications.org/content/123/6/e1005.full.html\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. ; Available from: https://pediatrics.aappublications.org/content/123/6/e1005?sso=1\\u0026amp;sso_redirect_count=1\\u0026amp;nfstatus=401\\u0026amp;nftoken=00000000-0000-0000-0000-000000000000\\u0026amp;nfstatusdescription=ERROR%3A No local token\\u0026amp;utm_source = TrendMD\\u0026amp;utm_medium = TrendMD\\u0026amp;utm_campaign = Pediatrics_TrendMD_0\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDavis L (1992) Instrument Review: Getting the Most From a Panel of Experts. ;194\\u0026ndash;7\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eNational Coffee Association. 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Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.healthline.com/nutrition/caffeine-in-tea-vs-coffee\\u003c/span\\u003e\\u003cspan address=\\\"https://www.healthline.com/nutrition/caffeine-in-tea-vs-coffee\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJoakim (2020) How Much Caffeine In Cappuccino_ Crunching Numbers _ Art of Barista [Internet]. Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://artofbarista.com/how-much-caffeine-in-cappuccino/\\u003c/span\\u003e\\u003cspan address=\\\"https://artofbarista.com/how-much-caffeine-in-cappuccino/\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCaffeine Informer. Caffeine in Starbucks Bottled Iced Coffee [Internet] (2020) Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.caffeineinformer.com/caffeine-content/starbucks-bottled-iced-coffee\\u003c/span\\u003e\\u003cspan address=\\\"https://www.caffeineinformer.com/caffeine-content/starbucks-bottled-iced-coffee\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eStarbuks Coffee Company. Mango Dragonfruit Lemonade Starbucks Refreshers\\u0026reg; Beverage_ Starbucks Coffee Company [Internet] (2020) Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.starbucks.com/menu/product/2122726/iced?parent=%2Fdrinks%2Fcold-drinks%2Fstarbucks-refreshers\\u003c/span\\u003e\\u003cspan address=\\\"https://www.starbucks.com/menu/product/2122726/iced?parent=%2Fdrinks%2Fcold-drinks%2Fstarbucks-refreshers\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCaffeine Informer. Caffeine in Coca-Cola Classic [Internet] (2020) Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.caffeineinformer.com/caffeine-content/coca-cola-classic\\u003c/span\\u003e\\u003cspan address=\\\"https://www.caffeineinformer.com/caffeine-content/coca-cola-classic\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCaffeine Informer. Caffeine in Pepsi [Internet] (2020) Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.caffeineinformer.com/caffeine-content/pepsi-cola\\u003c/span\\u003e\\u003cspan address=\\\"https://www.caffeineinformer.com/caffeine-content/pepsi-cola\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCaffeine Informer. Caffeine in Red Bull [Internet] (2020) Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.caffeineinformer.com/caffeine-content/red-bull\\u003c/span\\u003e\\u003cspan address=\\\"https://www.caffeineinformer.com/caffeine-content/red-bull\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCaffeine Informer. Caffeine in Power Horse Energy Drink (EU) [Internet]. Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.caffeineinformer.com/caffeine-content/power-horse-energy-drink\\u003c/span\\u003e\\u003cspan address=\\\"https://www.caffeineinformer.com/caffeine-content/power-horse-energy-drink\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCohen J, QUANTITATIVE METHODS IN (1992) PSYCHOLOGY 112(1):155\\u0026ndash;159\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMobasseri M, Shirmohammadi M, Amiri T, Vahed N, Fard HH (2020) Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. 10(2):98\\u0026ndash;115\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSchnurbein J, Von, Boettcher C, Brandt S, Karges B, Dunstheimer D, Galler A et al (2017) Sleep and glycemic control in adolescents with type 1 diabetes. ;(April):1\\u0026ndash;7\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSilva R, Ganen A, Fernades V, Evangelista N, Figneiredo C, Pacheco L et al (2021) Evaluation of sleep characteristics of children and adolescents with type 1 diabetes mellitus Avalia\\u0026ccedil;\\u0026atilde;o das caracter\\u0026iacute;sticas do sono em crian\\u0026ccedil;as e adolescentes. ;1\\u0026ndash;7\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDewan M (2017) TV Viewing and computer use: The Independent factors accountable for overweight risk and. diabetes in Children 36(1):31\\u0026ndash;37\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRose S, Boucher SE, Galland BC, Stanley J, Smith C, Bock MI, De et al (2021) Impact of high-risk glycemic control on habitual sleep patterns and sleep quality among youth (13\\u0026ndash;20 years) with type 1 diabetes mellitus compared to controls without diabetes. ;(March):1\\u0026ndash;9\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFrye SS, Perfect MM, Silva GE (2019) Diabetes management mediates the association between sleep duration and glycemic control in youth with type 1 diabetes mellitus. Sleep Med [Internet]. ;60:132\\u0026ndash;8. Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1016/j.sleep.2019.01.043\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.sleep.2019.01.043\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBergner EM, Hamburger ER, Lyttle M, Davis AC, Malow B, Lybarger C et al (2018) Sleep in Teens With Type 1 Diabetes. ;541\\u0026ndash;548\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFortins R, Lacerda E, Silverio R, Carmo C, Ferreira A, Felizardo C et al (2019) Predictor factors of glycemic control in children and adolescents with type 1 diabetes mellitus treated at a referral service in Rio de Janeiro, Brazil. ;4\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBłaszczyk-Bebenek E, Jagielski P, Schlegel-Zawadzka M (2021) Caffeine Consumption in a Group of Adolescents from South.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDrewnowski A, Rehm CD (2016) Sources of Caffeine in Diets of US Children and Adults. Trends by Beverage Type and Purchase Location\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDewar L, Heuberger R (2017) The effect of acute caffeine intake on insulin sensitivity and glycemic control in people with diabetes. Diabetes Metab Syndr Clin Res Rev [Internet]. ; Available from: \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttp://dx.doi.org/10.1016/j.dsx.2017.04.017\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.dsx.2017.04.017\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-3260865/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-3260865/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"AIM: The present study aimed to examine the association between caffeine intake and glycemic control as measured by HbA1c levels among adolescents with type 1 diabetes mellitus.\\r\\nMETHOD: A cross-sectional study of eligible 96 adolescents aged between 13 to 18 years old with type 1 diabetes mellitus from three governmental hospitals and one university hospital in Jordan. Descriptive analysis was done to describe sample characteristics as well as using correlation to find the relationship between caffeine intake and glycemic control.\\r\\nRESULTS: The mean age of adolescents was 14.7 years old. 95.8% used the subcutaneous insulin injection method and only 4.2% used an insulin pump. 84.4% of adolescents were diagnosed with type 1 diabetes mellitus for more than one year. The mean HbA1c level was 9.3%. Study results showed that the mean daily caffeine intake was 286.7 mg which was associated with glycemic control as measured by HbA1c level.\\r\\nCONCLUSION: Modifying the amount of daily caffeine intake may be a proper target to get better glycemic control, especially among adolescents with type 1 diabetes mellitus.\",\"manuscriptTitle\":\"The Association Between Caffeine Intake And Glycemic Control Among Adolescents With Type 1 Diabetes Mellitus\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2023-08-28 19:03:16\",\"doi\":\"10.21203/rs.3.rs-3260865/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"2a9e7071-9cb4-4e45-b94d-cf1916b9fa8c\",\"owner\":[],\"postedDate\":\"August 28th, 2023\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":24084019,\"name\":\"Health sciences/Health care/Nutrition\"},{\"id\":24084020,\"name\":\"Health sciences/Health care/Paediatrics\"},{\"id\":24084021,\"name\":\"Health sciences/Diseases/Endocrine system and metabolic diseases/Diabetes/Type 1 diabetes\"}],\"tags\":[],\"updatedAt\":\"2023-10-30T16:41:18+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2023-08-28 19:03:16\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-3260865\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-3260865\",\"identity\":\"rs-3260865\",\"version\":[\"v1\"]},\"buildId\":\"WrCJVZZCHTDjtuVLN7oU0\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}