Carbohydrate Counting May Improve Metabolic Control, Quality of Life in Pediatric Diabetes Patients

A study assessed the impact of advanced carbohydrate counting versus standard nutrition on metabolic control and quality of life (QOL) in children with type 1 diabetes (T1D) and concluded that carbohydrate counting may result in small improvements in outcomes over traditional nutrition.

The study randomized 87 patients (age, 9.6±3.5 years; diabetes duration, 4.6±2.7 years; glycated hemoglobin [HbA1c], 7.8±0.5% [62±5 mmol/mol]) to either the advanced carbohydrate counting group, which received carbohydrate counting education, or a control group, which received traditional dietary education. Patients underwent HbA1c measurement once every three months for one year. Outcomes included general QOL (per the KIDSCREEN and World Health Organization-5 questionnaires), diabetes-specific QOL (per the diabetes-specific module of the DISABKIDS), and diet-related QOL (per the diet restriction items of the Diabetes-Specific Quality of Life (DSQOL) at baseline compared with one year.

At three months, the advanced carbohydrate counting group had a lower mean HbA1c than the control group (P<0.05); this tended to be the case at six (P=0.10) and nine (P=0.10) months, but not at one year. Over the course of the study, the mean individual average HbA1c was 7.63±0.43% in the advanced carbohydrate counting group compared with 7.85±0.47% in the control group (60±5 vs. 62±5 mmol/mol; P<0.05). At one year, the advanced carbohydrate counting group had significantly higher scores on the KIDSCREEN children’s psychological scale and the KIDSCREEN parents’ physical scale, the DISABKIDS children’s treatment scale, and the children’s and parents’ dietary restriction scales of the DSQOL.

The study authors concluded that the advanced carbohydrate counting intervention may be correlated with small improvements in metabolic control and QOL in children with T1D.