T1DM: Carbohydrate Management Strategies (2023)
In children and adolescents (6-19 years old) living with type 1 diabetes, what is the effect of carbohydrate management strategies (e.g.: carbohydrate counting alone; carbohydrate counting using insulin-to-carbohydrate ratios; carbohydrate consistency; plate method; exchange lists/food lists/carbohydrate choices) compared to usual care on A1C and quality of life scores?
In children and adolescents (6-19 years old) living with type 1 diabetes, evidence suggests that carbohydrate counting (using insulin-to-carbohydrate ratio) can be an effective strategy to help reduce and provide continued maintenance of A1C goals. Small improvements in quality-of-life scores and overall confidence in prescribed dietary advice compared to other carbohydrate management strategies like carbohydrate consistency, plate method or exchange lists/food lists/carbohydrate choices were identified.
Grade: Low (C)
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
Evidence Summary: In children and adolescents (6-19 years old) living with type 1 diabetes, what is the effect of carbohydrate management strategies (e.g.: carbohydrate counting alone; carbohydrate counting using insulin-to-carbohydrate ratios; carbohydrate consistency; plate method; exchange lists/food lists/carbohydrate choices) compared to usual care on A1C and quality of life scores?
- Quality Rating Summary
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- Dalsgaard H, Saunders C, Padilha P, Luescher J, Szundy Berardo R, Accioly E. Glycemic control and lipid profile of children and adolescents undergoing two different dietetic treatments for type 1 diabetes mellitus. Nutricion Hospitalaria 2014; 29:547-552
- Donzeau A, Bonnemaison E, Vautier V, Menut V, Houdon L, Bendelac N, Bismuth E, Bouhours-Nouet N, Quemener E, Baron S, Nicolino M, Faure N, Pochelu S, Barat P, Coutant R. Effects of advanced carbohydrate counting on glucose control and quality of life in children with type 1 diabetes. Pediatric Diabetes 2020; 21:1240-1248
- Enander R, Gundevall C, Strömgren A, Chaplin J, Hanas R. Carbohydrate counting with a bolus calculator improves post-prandial blood glucose levels in children and adolescents with type 1 diabetes using insulin pumps. Pediatric Diabetes 2012; 13:545-551
- Göksen D, Atik Altinok Y, Ozen S, Demir G, Darcan S. Effects of carbohydrate counting method on metabolic control in children with type 1 diabetes mellitus. Journal of Clinical Research in Pediatric Endocrinology 2014; 6:74-78
- Kostopoulou E, Livada I, Partsalaki I, Lamari F, Skiadopoulos S, Rojas Gil A, Spiliotis B. The role of carbohydrate counting in glycemic control and oxidative stress in patients with type 1 diabetes mellitus (T1DM). Hormones (Athens, Greece) 2020; 19:433-438
- Rabbone I, Scaramuzza A, Ignaccolo M, Tinti D, Sicignano S, Redaelli F, De Angelis L, Bosetti A, Zuccotti G, Cerutti F. Carbohydrate counting with an automated bolus calculator helps to improve glycaemic control in children with type 1 diabetes using multiple daily injection therapy: an 18-month observational study. Diabetes Research and Clinical Practice 2014; 103:388-394
- Sauder K, Stafford J, The N, Mayer-Davis E, Thomas J, Lawrence J, Kim G, Siegel K, Jensen E, Shah A, D'Agostino R, Dabelea D. Dietary strategies to manage diabetes and glycemic control in youth and young adults with youth-onset type 1 and type 2 diabetes: The SEARCH for diabetes in youth study. Pediatric Diabetes 2020; 21:1093-1101
- Spiegel G, Bortsov A, Bishop F, Owen D, Klingensmith G, Mayer-Davis E, Maahs D. Randomized nutrition education intervention to improve carbohydrate counting in adolescents with type 1 diabetes study: is more intensive education needed?. Journal of the Academy of Nutrition and Dietetics 2012; 112:1736-1746
Search Plan and Results: T1DM: Interventions 2023