Impact of carbohydrate counting on glycemic control in children with type 1 diabetes

Diabetes Care. 2009 Jun;32(6):1014-6. doi: 10.2337/dc08-2068. Epub 2009 Feb 24.

Abstract

Objective: To study the association between parent carbohydrate counting knowledge and glycemic control in youth with type 1 diabetes.

Research design and methods: We assessed 67 youth ages 4-12 years with type 1 diabetes (duration >or=1 year). Parents estimated carbohydrate content of children's meals in diet recalls. Ratios of parent estimates to computer analysis defined carbohydrate counting knowledge; the mean and SD of these ratios defined accuracy and precision, respectively. A1C defined glycemic control.

Results: Greater accuracy and precision were associated with lower A1C in bivariate analyses (P < 0.05). In a multivariate analysis (R(2)= 0.25, P = 0.007) adjusting for child age, sex, and type 1 diabetes duration, precision (P = 0.02) and more frequent blood glucose monitoring (P = 0.04), but not accuracy (P = 0.9), were associated with lower A1C. A1C was 0.8% lower (95% CI -0.1 to -1.4) among youth whose parents demonstrated precision.

Conclusions: Precision with carbohydrate counting and increased blood glucose monitoring were associated with lower A1C in children with type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism*
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood*
  • Diet, Diabetic
  • Dietary Carbohydrates / metabolism*
  • Energy Intake
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Male
  • Monitoring, Physiologic / methods
  • Multivariate Analysis
  • Reproducibility of Results

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Glycated Hemoglobin A