Carbohydrate Counting Improves Glycemic Control for Type 1s

Monitoring carbohydrate intake is an important part of glycemic control strategy in type 1 diabetes (T1DM). However, there is little data on its efficacy in T1DM patients on continuous subcutaneous insulin infusion (CSII).

The impact of carbohydrate monitoring on the quality of life (QoL) of these patients was investigated in a prospective, randomized, controlled, open-label study. A total of 61 T1DM adults patients on CSII were randomly assigned to one of two nutritional management strategies. The interventional group was trained to quantify their carbohydrate intake and undertake diet restrictions; the control group estimated premeal insulin dose the standard way.

Evaluations were performed at baseline, 12 and 24 weeks and included glycated hemoglobin (HbA1c), fasting plasma glucose, body mass index (BMI), adiposity and QoL assessment using the Diabetes-Specific QoL Scale (DSQOLS) instrument. Based on per-protocol analysis at week 24, significantly more reductions in HbA1c, BMI and waist circumference were observed in the interventional versus control group. Diet restrictions in the interventional patients also resulted in higher DSQOLS scores versus controls, indicating improvement in QoL, without increased incidence of hypoglycemia.

The results showed that carbohydrate quantification is an effective and safe strategy to manage glycemia and improve QoL in T1DM patients.