ObesityWeek

ObesityWeek

November 11, 2013
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Carbohydrate counting vs. usual care may improve glycemic control

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Carbohydrate counting may be a beneficial dietary strategy compared with alternative advice or usual care in adults with type 1 diabetes, according to data from a systematic review and meta-analysis. However, further studies should investigate this method to ensure insulin dose is matched to food, researchers wrote.

They compared carbohydrate counting with general or alternate dietary advice in seven trials consisting of 311 studies from multiple databases. They included 599 adults and 104 children with type 1 diabetes.

When looking at all studies, no significant improvements to HbA1c with carbohydrate counting vs. the control or usual care were observed (−0.35%; 95% CI, −0.75 to 0.06), according to data.

Significant heterogeneity (P<.0001) discovered between studies could be due to varying study designs, the researchers wrote.

But, according to data from the five parallel designed studies including adults, there was a 0.64% point reduction in HbA1c with carbohydrate counting compared with controls (95% CI, −0.91 to −0.37).

“Indeed, this meta-analysis shows the scarcity of high-level evidence,” the researchers wrote. “Five studies suggest carbohydrate counting is better than usual care, but there are too few studies comparing carbohydrate counting with similarly intensive but different methods of matching insulin to food.”

Disclosure: Bell and Colagiuri report being coauthors of lay books about the glycemic index of foods. They are also directors of the Glycemic Index Foundation, a non-profit company that administers food endorsement programs based on the glycemic index of foods. All other researchers report no relevant financial disclosures.