Parents’ Skill at Carb Counting Linked to Diabetic Kids’ A1c Levels

Parental precision at carbohydrate counting is associated with improved glycemic control in children with Type 1 diabetes, according to a paper in the June issue of Diabetes Care.

Dr. Sanjeev N. Mehta of Harvard Medical School in Boston and colleagues interviewed the parents of 67 children with Type 1 diabetes. The children were ages 4 to 12 years (mean age 9.1 years) with diabetes duration of at least 1 year (average, 4.1 years). Parents were asked to estimate the carbohydrate content of the children’s meals during the previous 24 hours.

Overall, based on 182 parent interviews (average 2.7 per family), parent estimates of carbohydrate intake were 120% of intake as calculated using Nutrition Data System for Research (NDSR) software.

With accuracy defined by estimates within 20% of calculated intake and precision as values less than the 75th percentile, multivariate analysis showed that lower A1c was associated with precision (p=0.02) and more frequent blood glucose monitoring (p=0.04) but not with accuracy, the researchers report.

A1c was 0.8% lower in children “whose parents demonstrated precision,” according to the report.

“Over the last 10 to 15 years, the adoption of new insulins and methods for insulin delivery (e.g., insulin pens and pump therapy) has facilitated diabetes care for youth with Type 1 diabetes,” Dr. Mehta said in an interview. “Our findings suggest, however, that careful attention to meal-planning remains important for diabetes management…. I hope that these findings highlight the importance of ensuring that families living with Type 1 diabetes are properly educated in this area.”

Diabetes Care 2009;32:1014-1016.