International Society for Pediatric and Adolescent Diabetes
ISPAD 2014 | 40th Anniversary |
223
P132
Carb counting technique in children and adolescents with type 1 diabetes: effect on metabolic
control, dietary habits, lifestyle, quality of life and body composition
C. Maffoni
1
, S. Salvatore
2
, A. Salvatoni
2
1
Filippo del Ponte Hospital, Varese, Italy,
2
University of Insubria, Varese, Italy
Objectives:
To test an educational instrument suitable to help patients in adjusting insulin dose to
their eating habits, in order to avoid diet prohibition perception and to improve dietary independence
maintaining a fair metabolic control.
Methods:
Sixty-three patients aged 14±3 yr (Median±IQR) affected by type 1 diabetes treated by
Multiple Daily Injections Therapy (MDI) or Continuous Subcutaneous Insulin Infusion (CSII), were
divided in three groups: group A who attended a one weekend carbohydrate counting course; group B
already using carb counting; group C not using carb counting. Every patient was evaluated at
enrollment (T0), after three (T1), six (T2), twelve (T3) and eighteen months (T4). At T0, every patient
enrolled was asked to fill a questionnaire about his/her use of carb counting. Those who declared not
to use this technique were invited to take part to an intensive multi-disciplinary course on carb
counting. During the study we monitored HbA1c, frequency of blood glucose monitoring, type of
therapy, quality of life, food diary, anthropometric measures and lifestyle. Wilkoxon signed-rank and
Kruskal-Wallis tests were used as appropriate for statistical analysis.
Results:
The parameters analyzed were similar among the three groups at T0 and during the follow-
up period. A significant increase in fat free mass (p< .02), a decrease in fat mass (p< .02), a decrease
in consumption of saturated fats (p< .02) and simple sugars (p< .05), a decrease in glycemic index (p<
.05) and energy density of diet (p< .02) were observed only in group A at T4 compared to T0. We
found no significant change of QoL, lifestyle and metabolic control in the three groups comparing T0
and T4.
Conclusions:
In accordance with a previous trial (Spiegel G, 2012), education to carb counting is not
sufficient to improve metabolic control and QoL at medium term. We showed that carb counting
improves body composition and dietary habits and allows a better perceived dietary freedom.
