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Carbohydrate counting implementation on pediatric type 1 diabetes mellitus: systematic review and meta-analysis

Lowilius Wiyono1, Nida Ghitha1, Dina Clarisa1

  • 1Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Annals of Pediatric Endocrinology & Metabolism
|October 6, 2023
PubMed

Insights

Carbohydrate counting effectively reduces hemoglobin A1c (HbA1c) in children with type 1 diabetes mellitus. This management strategy improves glycemic control, offering a valuable approach for pediatric diabetes care.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Evidence-Based Medicine

Background:

  • Type 1 diabetes mellitus (T1DM) is the most prevalent form of diabetes in children.
  • Effective management of T1DM is crucial for preventing long-term complications and maintaining quality of life.
  • Carbohydrate counting is a key dietary management strategy for T1DM.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy of carbohydrate counting in reducing HbA1c levels in pediatric T1DM patients.
  • To evaluate the impact of carbohydrate counting on glycemic control in children with T1DM.

Main Methods:

  • A systematic review and meta-analysis of nine relevant studies.
  • Searched electronic databases including ProQuest, PubMed, Scopus, and ScienceDirect.
  • Assessed study quality using risk of bias and JBI Critical Appraisal tools.
  • Performed quantitative analysis and forest plot extrapolation.

Main Results:

  • Meta-analysis of nine studies involving pediatric T1DM patients demonstrated a significant reduction in HbA1c.
  • Carbohydrate counting intervention resulted in a mean HbA1c difference of -0.55 (95% CI, -0.81 to -0.28; P<0.001) compared to control groups.
  • High heterogeneity (I2=88%) was noted across the included studies, indicating variability in results.

Conclusions:

  • The meta-analysis provides evidence supporting the use of carbohydrate counting in managing T1DM in children.
  • Carbohydrate counting is an effective intervention for improving glycemic control in pediatric patients with type 1 diabetes mellitus.
Abstract

Keywords:
Carbohydrate countingChildGlycated hemoglobinQuality of lifeType 1 diabetes mellitus

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