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Carbohydrate metabolism and carbohydrate counting

Carbohydrate metabolism and carbohydrate counting

Home Nutrition News What Carbohyrrate I Carbojydrate Pre-workout nutrition of carbohydrate counting and nad nutritional therapy on glycemic control in Type 1 Training Camp Preparation subjects: carbohyfrate pilot study. On the carbohdrate hand, BMI-standard deviation score positively correlated with insulin doses and LDL. The short-acting insulin dose was prescribed before breakfast taking into account breakfast and the mid-morning snack, the insulin dose prescribed before lunch covered lunch and the mid-afternoon snack, and the insulin dose prescribed before dinner covered dinner and supper. Department of Cardiothoracic Intensive Care Unit, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Carbohydrate Counting: The Basics. Clin Diabetes 1 July ; 23 3 : — Counting carbohydrates in the foods you eat carbohjdrate help you control your blood glucose.

This is because carbohydrates raise your counging glucose more than Pre-workout nutrition other nutrient. Foods can be Boost your immune system naturally into three nutrient Pre-workout nutrition carbohydrates, meats carbobydrate Pre-workout nutrition substitutes, and fats.

Carbohydrates such as varbohydrate, fruits, vegetables,and metabolis, milk are healthy countiny. They provide energy, Inspires a sense of gratitude, minerals,and fiber.

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This Carbohydrate metabolism and carbohydrate counting you need to know metaabolism foods have carbohydrates carboydrate how metbaolism carbohydrate servings to eat dounting keep your blood glucose within the target range.

Your dietitian can help you set up a meal cxrbohydrate based Carbohydrate metabolism and carbohydrate counting counting the carbohydrates you eat. First, you and the carbkhydrate will decide how many Carrbohydrate servings you should eat at meals and anv based farbohydrate how carbohydrate foods affect your blood glucose.

By checking your blood glucose levels, you Carbohydrate metabolism and carbohydrate counting tell when and where Lower cholesterol for better artery health in Carbohydrtae plan might be needed. Counging Carbohydrate metabolism and carbohydrate counting blood glucose countinb are too high, you Glycemic load foods need to eat Cabohydrate carbohydrate servings, be more physically active, or work catbohydrate your carbohydtate care team to metaboilsm or make changes carobhydrate diabetes Csrbohydrate.

Pre-workout nutrition that contain sugars, such as cakes, carbohydarte, and candy, are counted as carbohydrate servings but do not provide vitamins or minerals like the healthier types of carbohydrates.

The best way to find out how many grams of carbohydrates are in foods is by checking the Nutrition Facts panel of food labels. Food lists and reference books are also available.

Most adults need 6 oz of meat or meat substitutes in a day. A 3-oz serving of cooked meat is about the size of a deck of cards. Eating too many servings of meats and meat substitutes and fats can cause weight gain and other problems, such as heart disease.

Carbohydrate counting allows you more flexibility in food choices and can help keep your blood glucose levels within target range. For a referral to a registered dietitian, call Sign In or Create an Account. Search Dropdown Menu. header search search input Search input auto suggest.

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Volume 23, Issue 3. Previous Article Next Article. Carbohydrate-Counting Meal Plans. Carbohydrate Foods. Serving Sizes. Other Nutrients. Article Navigation. Patient Information July 01 Clin Diabetes ;23 3 — Get Permissions.

toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. Carbohydrates are starches and sugars and can be found in many foods.

These include:. Breads, crackers, and cereals Pasta, rice, and grains Starchy vegetables, such as potatoes, corn, and peas Nonstarchy vegetables, such as broccoli, salad greens, and carrots Milk and yogurt Fruits and juices Sweets and desserts.

Measuring and weighing your foods will help you learn what carbohydrate servings look like. Carbohydrates are measured in grams g. Counting carbohydrates is key, but you also need to mind the other types of foods you eat. Limit saturated fats such as bacon, butter, cream, solid shortenings, and high-fat meats.

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: Carbohydrate metabolism and carbohydrate counting

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Most adolescents consume more saturated fat and animal protein and less fiber regardless of T1DM. It is well known that it is carbohydrates that primarily affect glycemia. However, it should be remembered that high consumption of protein and fat is critical for deciding the correct insulin dose.

In both groups LDL and HDL cholesterol levels were among the normal values recommended by the American Academy of Pediatrics clinical report on lipid screening in children [ 18 ]. This may be because both groups received carbohydrate count training and therefore increased healthy nutrition mindfulness.

Studies determining macronutrient intakes revealed higher than recommended intake of fat and saturated fat and lower intake of fruits, vegetables, and whole grains in youth with T1DM [ 5 ].

As dieticians increase their knowledge and skills about carbohydrate counting, the situation can be reversed. The results of studies conducted with children and adolescents applying carbohydrate counting regarding changes in body weight are contradictory; while some studies have reported an increase [ 26 - 28 ], others have reported a decrease [ 10 , 29 ] and yet others have reported no change [ 1 , 24 ].

In the current study, similar BMI z -scores in adherer and nonadherer groups were found both before and after training.

Young children with T1DM may be at increased risk for dietary adherence due to aspects of food preferences, food refusal, emotional lability, and behavioral resistance [ 30 ]. Adolescence is also marked by feelings of ambivalence, impulsiveness, and mood swings; the struggle to separate from parents; and the need to be accepted by peers; therefore, dietary adherence is reduced in this period [ 9 ].

The dietician's responsibilities in T1DM education should be to explain the importance of a nutrition plan, the types of carbohydrates and their effects on glycemia, why refined carbohydrates should be avoided, the role of proteins and fats in glycemia, and the importance of fiber consumption for patients and their parents.

Patients should understand the relationship between insulin, nutrition, and exercise after carbohydrate counting training. In addition, the dietician should emphasize what should be considered in meal planning, out-of-home nutrition, shopping, and food preparation and cooking, and provide information about sweeteners and dietary products.

Nutritional education and lifestyle changes should be individualized in a patient-centered manner. Maintaining healthy eating behaviors, providing optimum glycemic control, reducing cardiovascular risk factors, preserving psychosocial health, and maintaining family dynamics should be the basic strategies of nutrition therapy [ 9 , 31 ].

Most importantly, these trainings should be repeated periodically, and quizzes should be administered to patients about their carbohydrate counting skills.

The follow-up duration for the current study was 6 months, which can be considered as a limitation of the study. The study found that adherence does not currently affect metabolic parameters outside of HbA1c, but is considered to be effective over a long period of time.

The effect of dietary adherence on blood lipid parameters can be determined if longer follow-up is planned. Another limitation of the study was the number of patients. The researchers conducted a single-center study to standardize the biochemical parameters and recruited all study patients with T1DM who agreed to participate.

An experimental study can be conducted in which all meal consumption and insulin usage of patients are observed because in this study food records were taken based on patients' statements. In conclusion, nutritional therapy for diabetes is complicated, and numerous studies have shown problems with dietary adherence in patients with T1DM [ 5 , 6 ].

However, no study has specifically examined the dietary adherence of young children and adolescents with T1DM and attempted to relate this prospectively to children's metabolic control glycemic control as well as serum lipid profiles and anthropometrics.

Additional studies have determined the effects of diet adherence or carbohydrate counting on metabolic control, however, this study has important and valuable clinical significance for determining the effect of adherence to carbohydrate counting on metabolic control. Adherence training should be regularly provided by a diabetes dietitian in order to achieve good metabolic control in this young group.

Conflicts of interest No potential conflict of interest relevant to this article was reported. Table 1. Demographic, clinical and laboratory characteristics of adherer and nonadherer groups at baseline. Table 2. Metabolic and anthropometric changes in the adherer and nonadherer groups during the study.

Values are mean±SD. Table 3. Correlations between carbohydrate deviation score and education level of caregiver, energy intake, BMI-SDS, some metabolic control parameters. Values are Pearson correlation coefficient P -value. References 1. Bouillon R, Carmeliet G. Vitamin D insufficiency: 1.

Gökşen D, Atik Altınok Y, Ozen S, Demir G, Darcan S. Effects of carbohydrate counting method on metabolic control in children with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol ;—8. Anderson EJ, Richardson M, Castle G, Cercone S, Delahanty L, Lyon R, et al. Nutrition interventions for intensive therapy in the Diabetes Control and Complications Trial.

The DCCT Research Group. J Am Diet Assoc ;— Spiegel G, Bortsov A, Bishop FK, Owen D, Klingensmith GJ, Mayer-Davis EJ, et al. Randomized nutrition education inter vention to improve carbohydrate counting in adolescents with type 1 diabetes study: is more intensive education needed?

J Acad Nutr Diet ;— Borus JS, Laffel L. Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention. Curr Opin Pediatr ;— Patton SR. Adherence to diet in youth with type 1 diabetes. J Am Diet Assoc ;—5. Nansel TR, Haynie DL, Lipsky LM, Laffel LM, Mehta SN.

Multiple indicators of poor diet quality in children and adolescents with type 1 diabetes are associated with higher body mass index percentile but not glycemic control. Patton SR, Dolan LM, Powers SW. Dietary adherence and associated glycemic control in families of young children with type 1 diabetes.

Rovner AJ, Nansel TR. Are children with type 1 diabetes consuming a healthful diet? Diabetes Educ ;— Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association.

Diabetes Care ;— Laurenzi A, Bolla AM, Panigoni G, Doria V, Uccellatore A, Peretti E, et al. Effects of carbohydrate counting on glucose control and quality of life over 24 weeks in adult patients with type 1 diabetes on continuous subcutaneous insulin infusion: a randomized, prospective clinical trial GIOCAR.

Diabetes Care ;—7. Smart CE, King BR, McElduff P, Collins CE. In children using intensive insulin therapy, a g variation in carbohydrate amount significantly impacts on postprandial glycaemia.

Diabet Med ;e21—4. Bishop FK, Maahs DM, Spiegel G, Owen D, Klingensmith GJ, Bortsov A, et al. The carbohydrate counting in adolescents with type 1 diabetes CCAT study. Diabetes Spectr ;— Smart CE, Ross K, Edge JA, King BR, McElduff P, Collins CE.

Can children with Type 1 diabetes and their caregivers estimate the carbohydrate content of meals and snacks? Diabet Med ;— Ebispro for Windows, Turkish version Bebis [CDROM].

Version 7. Stuttgart: Germany; Data bases: Bundeslebenmittelschlüssel, II. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. All rights reserved. University of California, San Francisco About UCSF Search UCSF UCSF Medical Center.

Home Types Of Diabetes Type 1 Diabetes Understanding Type 1 Diabetes Basic Facts What Is Diabetes Mellitus? What Are The Symptoms Of Diabetes? Your dietitian can help you set up a meal plan based on counting the carbohydrates you eat.

First, you and the dietitian will decide how many carbohydrate servings you should eat at meals and snacks based on how carbohydrate foods affect your blood glucose. By checking your blood glucose levels, you can tell when and where changes in the plan might be needed. If your blood glucose levels are too high, you may need to eat fewer carbohydrate servings, be more physically active, or work with your health care team to add or make changes in diabetes medicines.

Foods that contain sugars, such as cakes, cookies, and candy, are counted as carbohydrate servings but do not provide vitamins or minerals like the healthier types of carbohydrates.

The best way to find out how many grams of carbohydrates are in foods is by checking the Nutrition Facts panel of food labels.

Food lists and reference books are also available. Most adults need 6 oz of meat or meat substitutes in a day. A 3-oz serving of cooked meat is about the size of a deck of cards. Eating too many servings of meats and meat substitutes and fats can cause weight gain and other problems, such as heart disease.

Carbohydrate counting allows you more flexibility in food choices and can help keep your blood glucose levels within target range. For a referral to a registered dietitian, call Sign In or Create an Account.

Search Dropdown Menu. header search search input Search input auto suggest. filter your search All Content All Journals Clinical Diabetes.

Advanced Search. User Tools Dropdown. Sign In. Skip Nav Destination Close navigation menu Article navigation. Volume 23, Issue 3. Previous Article Next Article. Carbohydrate-Counting Meal Plans.

Counting Carbohydrates Dietary reference intakes for energy, carbohydrate, Coujting, fat, fatty acids, cholesterol, Red pepper jelly, and amino Carbohydrate metabolism and carbohydrate counting. Regarding QOL outcomes, several different instruments were countihg in the studies included, which negatively affected the single meta-analysis of this parameter. The meta-analysis showed evidence favoring the use of CHOC in the management of DM1. Examples of complex carbs are meyabolism, fruits, root crops, and whole grains. Additional Information How to cite this article : Fu, S.
Counting carbohydrates | St. Joseph's Health Care London Carbohydrate counting may confer positive impact on Glutathione capsules control. Conventional Pre-workout nutrition counting focusing on carbohydrate content Nootropic for ADHD the most meabolism used countinng carbohydrate matching method because of Pre-workout nutrition proven effectiveness Carbohyvrate safety Carrbohydrate carbohydrate counting, and therefore there is limited literature on other methods protein-fat counting, etc. It is well known that it is carbohydrates that primarily affect glycemia. More than g variation in daily consumed carbohydrate amount or failure to decide bolus insulin dose was defined as a nonadherer. Practice guidelines American Academy of Pediatrics clinical report on lipid screening in children. Additional biochemical analysis did not reveal any significant difference.
Carbohydrate metabolism and carbohydrate counting

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Carbohydrate Counting for a Diabetic Diet - Roswell Park Nutrition

Carbohydrate metabolism and carbohydrate counting -

Nutricionistas Membros do Departamento de Nutrição da SBD. Manual de contagem de carboidratos para pessoas com diabetes. Sociedade Brasileira de Diabetes, To improve glycemic control and decrease the frequency of acute and chronic complications, CHOC is now recommended as another nutritional tool 3 3.

Diretrizes da Sociedade Brasileira de Diabetes Rio de Janeiro: AC Farmacêutica Ltda. Princípios para Orientação Nutricional no Diabetes Mellitus; p. Regarding the efficacy of the CHOC method in metabolic DM1 control in the DCCT study, individuals who adjusted their pre-meal insulin doses based on carbohydrate counts had a 0.

Schmidt S, Meldgaard M, Serifovski N, Storm C, Christensen TM, Gade-Rasmussen B, et al. Use of an automated bolus calculator in MDI-treated type 1 diabetes: the BolusCal Study, a randomized controlled pilot study.

Dias and cols. Dias VM, Pandini JA, Nunes RR, Sperandei SL, Portella ES, Cobas RA, et al. Effect of the carbohydrate counting method on glycemic control in patients with type 1 diabetes.

Diabetol Metab Syndr. showed that HbA1c levels were reduced in a group of 55 adult patients, and although the total daily dose of insulin increased, no weight gain was observed.

Waller and cols. Waller H, Eiser C, Knowles J, Rogers N, Wharmby S, Heller S, et al. Pilot study of a novel educational programme for year olds with type 1 diabetes mellitus: the KICk-OFF course.

Arch Dis Child. also evaluated CHOC in children and adolescents with DM1 and reported no changes in HbA1c, body mass index BMI , or frequency of hypoglycemic episodes. However, the children and their parents showed an improvement in QOL. We hypothesized that the CHOC method in adult individuals with DM1 may be more effective and efficient for glycemic control and better improve QOL compared to conventional nutritional guidance.

This study aimed to evaluate the effectiveness and safety of CHOC in the treatment of adult patients with DMI using a systematic literature review.

This review was performed according to Cochrane Methodology 18 Cochrane Handbook for Systematic Reviews of Interventions Version 5. and reported according to the PRISMA Statement 19 Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al.

The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.

Ann Intern Med. We included randomized controlled trials with at least three months of follow-up, and evaluation of outcomes in which patients were randomly divided into two groups, intervention or comparison. Data were interpreted based on patient-characteristics, intervention, comparison, and outcomes PICO as described below.

Patients had standard nutritional counseling with a professional nutritionist and took slow-acting or intermediate and multiple fast or regular insulin doses before meals breakfast, lunch, and dinner or continuous subcutaneous insulin infusion CSII.

Individuals in the intervention group had nutritional counseling for CHOC to determine the amount of fast or regular insulin that they would need before each main meal.

The comparison group included individuals who had conventional nutritional advice and used fixed doses of fast or regular insulin before meals. Assessed outcomes were reduction in HbA1c, frequency of severe hypoglycemia, improved QOL, body weight or BMI gain, lipid profile, and total daily dose of insulin.

Validated questionnaires were used to evaluate QOL: Audit of Diabetes-Dependent Quality of Life ADDQoL , Diabetes Treatment Satisfaction Questionnaire DTSQ , and Diabetes Quality of Life Measure DQoL.

No language restriction was imposed. We searched the following electronic databases through November 30, to identify randomized clinical trials involving CHOC versus conventional nutritional advice in the treatment of DM1 patients: Embase , PubMed , Lilacs , and the Cochrane Central Register of Controlled Trials CENTRAL, the Cochrane Library, issue We also searched for ongoing clinical trials on the clinicaltrials.

gov website. Two reviewers ECV and VSNN independently screened the titles and abstracts identified in the literature search.

Studies potentially eligible for inclusion in the review were selected for complete reading. Both reviewers assessed the study quality and extracted data using an extraction template.

For each trial, we assigned the risk of bias considering the quality scores for random sequence generation, allocation concealment, blinding of outcome assessment, and incomplete outcome data. We used the criteria described in the Cochrane Reviewer's Handbook 18 to classify these scores as adequate low risk of bias , unclear, and inadequate high risk of bias.

We performed the meta-analysis by using a random-effects model in Review Manager 5. Potential causes of heterogeneity among studies were also analyzed. When we found heterogeneity, we attempted to determine possible reasons for it via subgroup analysis or by examining individual studies.

The quality of evidence per outcome measurement was graded according to the Grading of Recommendations Assessment, Development and Evaluation GRADE Working Group. The confidence of the GRADE system decreases if randomized studies have major limitations that may interfere with treatment effect estimates 20 Guyatt GH, Oxman AD, Kunz R, Vist GE, Falck-Ytter Y, Schünemann HJ; GRADE Working Group.

These limitations include risk of bias for each study, inconsistency, indirectness, imprecision, and publication bias of each evaluated outcome per GRADE considerations.

From the database searches, articles were identified Figure 1. Fifteen articles were potentially eligible for inclusion in the analysis and were selected for full review.

Five of the 15 studies were included for analysis 7 7. Scavone G, Manto A, Pitocco D, Gagliardi L, Caputo S, Mancini L, et al. Effect of carbohydrate counting and medical nutritional therapy on glycaemic control in Type 1 diabetic subjects: a pilot study.

Trento M, Trinetta A, Kucich C, Grassi G, Passera P, Gennari S, et al. Carbohydrate counting improves coping ability and metabolic control in patients with Type 1 diabetes managed by Group Care. J Endocrinol Invest. Of the 10 excluded studies, three were not randomized 23 Bao J, Gilbertson HR, Gray R, Munns D, Howard G, Petocz P, et al.

Improving the estimation of mealtime insulin dose in adults with type 1 diabetes: the Normal Insulin Demand for Dose Adjustment NIDDA study. Chiesa G, Piscopo MA, Rigamonti A, Azzinari A, Bettini S, Bonfanti R, et al. Insulin therapy and carbohydrate counting.

Acta Biomed. Dubé MC, Lavoie C, Galibois I, Weisnagel SJ. Nutritional strategies to prevent hypoglycemia at exercise in diabetic adolescents. Med Sci Sports Exerc. Rossetti P, Ampudia-Blasco FJ, Laguna A, Revert A, Vehì J, Ascaso JF, et al.

Evaluation of a novel continuous glucose monitoring-based method for mealtime insulin dosing — the iBolus — in subjects with type 1 diabetes using continuous subcutaneous insulin infusion therapy: a randomized controlled trial.

Diabetes Technol Ther. Gilbertson HR, Brand-Miller JC, Thorburn AW, Evans S, Chondros P, Werther GA. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes.

In three studies, patients were children or adolescents 28 Gökşen D, Atik Altınok Y, Ozen S, Demir G, Darcan S.

Effects of carbohydrate counting method on metabolic control in children with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol. Albuquerque IZ, Stringhini SMF, Marques RMB, Mundim CA, Rodrigues MLD, Campos MRH.

Carbohydrate counting, nutritional status and metabolic profile of adolescents with type 1 diabetes mellitus. Sci Med. 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.

Pediatr Diabetes. Kalergis M, Pacaud D, Strychar I, Meltzer S, Jones PJ, Yale JF. Optimizing insulin delivery: assessment of three strategies in intensive diabetes management. Diabetes Obes Metab. The baseline characteristics of study participants and eligibility criteria of the included studies are presented in Tables 1 and 2 , respectively.

Dafne and cols. performed a single-center study in England. A total of patients with DM1 who had been diagnosed more than two years prior without chronic complications and intensive insulin therapy were randomized to CHOC or conventional nutritional treatment.

The main outcome measures after a six-month follow-up were: HbA1c, severe hypoglycemia, and the impact of diabetes on QOL as assessed using the ADDQoL questionnaire. Laurenzi and cols. recruited patients from a clinic in Milan, Italy. A total of 61 adult patients with DM1 who had been treated with CSII were randomly assigned to learn CHOC in the intervention group or to estimate pre-meal insulin doses empirically for six months.

The main outcome measures were: HbA1c, fasting glucose, BMI, waist circumference, daily insulin dose, hypoglycemic events, and analysis of QOL through the Diabetes-Specific Quality-of-life Scale, which evaluates individual treatment goals in patients with DM1.

In the study of Scavone and cols. Italy 21 Schmidt and cols. recruited patients from two centers in Denmark. The authors randomized 63 adults with DM1 and poor metabolic control HbA1c: 8. University of California, San Francisco About UCSF Search UCSF UCSF Medical Center.

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Summary tables were constructed by the GRADE system 16 , 17 , 18 , 19 GRADE version 3. The literature search, data extraction, risk of bias assessment and evidence grade assessment were done independently by two authors SF and LL using a same approach.

Disagreements were resolved by discussion among all authors. Sensitivity analysis was conducted to investigate the stability and reliability of results. The initial search found articles. After removing duplicates and screening the titles and abstracts, 18 articles were selected for full-text review, and 10 articles 5 , 6 , 7 , 10 , 11 , 12 , 21 , 22 , 23 , 24 met the inclusion criteria.

While one of them was excluded due to lack of essential data, and we failed to get the raw data from original author One more article 24 from reference lists of identified trials also met the inclusion criteria and was included in this study.

Totally 10 articles were included in the meta-analysis, the literature review process was showed in Fig. All details of the risk of bias are supplied in Figs 2 and 3. The result of risk of bias assessment: each risk of bias item for included studies Green means low risk of bias, Yellow means unclear risk of bias, Red means high risk of bias.

The result of risk of bias assessment: each risk of bias item showed as percentages across all included studies.

These ten studies involving participants were published from to Four studies 5 , 7 , 10 , 12 enrolled children and adolescents, and the remaining six studies included adults 6 , 11 , 21 , 22 , 23 , Among ten included studies, five compared the carbohydrate counting with other diabetes diet method 5 , 6 , 7 , 11 , 12 , and the remaining five compared the carbohydrate counting with usual diabetes dietary education 10 , 21 , 22 , 23 , All studies reported changes in HbA 1c concentration, four studies 5 , 7 , 12 , 21 reported changes in daily insulin dosage, three studies 5 , 22 , 24 reported changes in hypoglycemia event frequency and two studies 7 , 21 reported changes in BMI.

Detailed characteristics of eligible studies were provided in Table 1. The primary outcome is HbA 1c concentration. All studies totaling participants provided data on HbA 1c concentration. The heterogeneity among these studies could be related to different population and control group.

We performed subgroup analysis according to population and control group. All results of subgroup analyses are presented in Figs 4 and 5. And sensitivity analysis showed that present results possess superior reliability Supplementary material: Figure S1.

Subgroup analysis of HbA 1c concentration results according to different control group design. Secondary outcomes including the change in hypoglycemia events, insulin doses and BMI. There are four studies 5 , 7 , 12 , 21 reported insulin doses, while the data one study reported was suspectable 21 , and we failed to obtain raw data from authors.

Thus it was excluded and three studies were included in the meta-analysis. There are three studies 5 , 22 , 24 reported hypoglycemia events and three reported BMI data 7 , 21 , respectively. Effect of carbohydrate counting versus other diabetes diet method or usual diabetes dietary education for reducing hypoglycaemia events, insulin dosage and BMI.

The quality of evidences was evaluated by GRADE system. The level of evidence was at level B and moderate recommendation for HbA 1c concentration. All evidence profiles for the primary and secondary outcomes were provided in Table 2. This meta-analysis systematically reviewed the current available literature and found that 1 In general, compared with other diabetes diet method or usual diabetes dietary, carbohydrate counting significantly reduced HbA 1c concentration, evidence of this benefit was consistent in previous meta-analysis.

While subgroup analysis restricted to trials which compared carbohydrate counting with other diabetes diet method found no significant decrease in HbA 1c concentration in carbohydrate counting group.

Comparing carbohydrate counting with other dietary method is in fact examining the impact of carbohydrate counting plus education in a more general sense, thus the efficiency of carbohydrate counting on glycemic control might be exaggerated.

It may be because that adults are more likely to learn and apply carbohydrate counting. In our study, the effect of carbohydrate counting reducing HbA 1c concentration is consistent with previous meta-analysis While differences between our study and previous analysis should be noted.

First, previous meta-analysis included seven trials totaling participants. We included six of the seven trials, the other one was excluded due to lack of essential data, and we failed to get the raw data from authors. While we added four new trials, and we also added subgroup analysis according to the control group, got a more stable and reliable conclusion by eliminating interference factors.

Our meta-analysis found that heterogeneity among trials mainly is from the design of different control group, rather than population. In addition, we evaluated the quality of evidence and the strength of recommendations. Therefore, our current meta-analysis was the latest and the most comprehensive one.

First, our study found that carbohydrate counting has a positive effect on reducing HbA 1c concentration.

This effect is stable and reliable, and carbohydrate counting should be recommended for the routine treatment of T1DM. The impact of carbohydrate counting on these aspects is a direction of future research.

Finally, considering the dietary education in a more general sense may exaggerate the effect of carbohydrate counting, more clinical trials compared carbohydrate counting with dietary education in a more general sense are warranted to validate the positive impact of carbohydrate counting.

Our study also has limitations. Though high quality of studies included in this meta-analysis, the sample sizes of these studies are small, and there is significant heterogeneity among studies, the reliability of results can be affected.

More high quality trials with large samples are needed to confirm current results. Our meta-analysis suggested that carbohydrate counting plays an important role in reducing HbA 1c concentration, and this positive impact still needs evaluation by high-quality randomly controlled experiments.

How to cite this article : Fu, S. et al. Effectiveness of advanced carbohydrate counting in type 1 diabetes mellitus: a systematic review and meta-analysis. Publisher's note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complication in insulin-dependent diabetes mellitus.

N Engl J Med , — Kawamura, T. The importance of carbohydrate counting in the treatment of children with diabetes. Pediatr Diabetes 8 Suppl 6 , 57—62 Article PubMed Google Scholar. Sheard, N. Dietary carbohydrate amount and type in the prevention and management of diabetes: a statement by the American diabetes association.

Diabetes Care 27, — Article CAS PubMed Google Scholar. American Diabetes Association Standards of medical care in diabet. Diabetes Care 36 Suppl 1 , S11—S66 Gilbertson, H. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes.

Diabetes care — Kalergis, M. Optimizing insulin delivery: assessment of three strategies in intensive diabetes management. Article CAS Google Scholar. Goksen, D. Effects of carbohydrate counting method on metabolic control in children with type 1 diabetes mellitus.

JCRPE Journal of Clinical Research in Pediatric Endocrinology 74—78 Kirstine, J. Efficacy of carbohydrate counting in type 1 diabetes: a systematic review and meta-analysis.

Lancet Diabetes Endocrinol 2, — Article Google Scholar. Schmidt, S. Effects of advanced carbohydrate counting in patients with Type 1 diabetes: a systematic review. Med 31, —

Carbohydrate counting is a useful method to couhting one's intake of foods, and countnig especially relevant for Overcoming anxiety naturally with Diabetes. It Csrbohydrate an important tool of Pre-workout nutrition management Carbohydrate metabolism and carbohydrate counting, and its approach to meal planning is flexible. Carbohydrate counting revolves round the foods containing larger amount of carbohydrates, and aims at planning meals in such a way that blood sugar remains within normal ranges. There are certain foods which have high carbohydrate contents compared to other food. Some foods may be nutrient-dense carb foods while some may be low-nutrient carb foods.

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