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Published on: June 11, 2012
Impact of carbohydrate counting on glycemic control in children with type 1 diabetes
Sanjeev N Mehta1, Nicolle Quinn, Lisa K Volkening
1Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts, USA. sanjeev.mehta@joslin.harvard.edu
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.
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