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Carbohydrate Counting vs. Fixed Meal Plan in Indian Children with Type 1 Diabetes Mellitus: A Randomized Controlled

Rajni Sharma1, Babita Upadhyay1, Nitika Lal1

  • 1Division of Pediatric Endocrinology, Department of Pediatrics, Mother and Child Block, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.

Indian Journal of Pediatrics
|October 3, 2023
PubMed

Insights

Carbohydrate counting in children with Type 1 diabetes mellitus (T1DM) reduced diabetes distress and emotional burnout compared to a fixed-meal plan. Glycemic control was similar between groups over six months.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes mellitus (T1DM) requires careful management of diet and insulin.
  • Dietary approaches include carbohydrate counting and fixed-meal plans.
  • Assessing the impact on psychosocial aspects is crucial for pediatric T1DM care.

Purpose of the Study:

  • To compare carbohydrate counting versus a fixed-meal plan in children with T1DM.
  • To evaluate effects on glycemic control (HbA1c).
  • To assess changes in quality of life (QoL) and diabetes-related emotional distress.

Main Methods:

  • A study involving children aged 6-18 years with T1DM on multiple daily insulin injections.
  • Intervention group received education on carbohydrate quantification and insulin adjustment.
  • Control group followed a prescribed diet; validated questionnaires assessed QoL and distress.

Main Results:

  • No statistically significant difference in HbA1c reduction between groups after 6 months.
  • The carbohydrate-counting group showed a significant reduction in diabetes distress scores (PAID).
  • Intervention group reported less emotional burnout compared to the control group.

Conclusions:

  • Carbohydrate counting in pediatric T1DM can decrease diabetes distress and emotional burnout.
  • Glycemic control remains comparable between carbohydrate counting and fixed-meal plans.
  • Dietary strategies should consider psychosocial well-being in T1DM management.
Abstract

Keywords:
Glycemic controlHbA1cInsulin carbohydrate ratioMedical nutrition therapyPAID score

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