The effect of the accuracy of carbohydrate counting on post prandial blood glucose variability in Type 1 Diabetes patients
Keywords:
carbohydrate counting, type 1 diabetes, 2-hour postprandial glucose levelAbstract
Carbohydrate counting is used to help calculate prandial insulin in type 1 diabetes (T1D) to achieve optimal postprandial glycemia. Thus, the accuracy of carbohydrate counting is essential. This study aimed to examine the association between the accuracy of carbohydrate counting and postprandial glucose levels in T1D patients who have completed the carbohydrate counting program, have assigned insulin to carbohydrate ratios and insulin sensitivity factors. In this prospective observational study, T1D patients recorded food intake, performed self-blood glucose monitoring (premeal and 2-hour postprandial), and submitted meal photographs for 4 days. Carbohydrate content was reviewed by two dietitians. Carbohydrate differences between the patients’ and the average of the dieticians’ were computed.
Result: Thirty patients participated. Carbohydrate counting was accurate in 85% of all meals (294/345). The mean absolute difference between patients’ and dietitians’ counting was 8.2 ± 6.3 g. The mean absolute difference
between pre and 2-hour postprandial glucose values was 28.8 ± 22.4 mg/dL. Greater differences between pre- and postprandial glucose values tended to correlate with greater differences between the patients’ and dieticians’
carbohydrate estimation, although not statistically significant (Spearman’s rho = 0.300, p-value = 0.107). The error of carbohydrate counting was greatest at dinner and significantly associated with higher postprandial glucose levels (Spearman’s rho = 0.293, p-value = 0.002).
Conclusion: T1D patients who completed carbohydrate counting program could accurately count carbohydrates,
with satisfactory postprandial glucose excursion. Although not statistically significant, the accuracy of carbohydrate counting tended to correlate with postprandial glucose excursion. The results support the benefits of carbohydrate counting in T1D patients.
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