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
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OBJECTIVE: Few studies have assessed the efficacy of carbohydrate counting in type 1 diabetes, and none have validated its efficacy in patients who are treated with continuous subcutaneous insulin infusion (CSII). The aim of our study was to test the effect of carbohydrate counting on glycemic control and quality of life in adult patients with type 1 diabetes who are receiving CSII. RESEARCH DESIGN AND METHODS: Sixty-one adult patients with type 1 diabetes treated with CSII were randomly assigned to either learning carbohydrate counting (intervention) or estimating pre-meal insulin dose in the usual empirical way (control). At baseline and 12 and 24 weeks, we measured HbA1c, fasting plasma glucose, BMI, waist circumference, recorded daily insulin dose, and capillary glucose data, and administered the Diabetes-Specific Quality-of-Life Scale (DSQOLS) questionnaire. RESULTS: Intention-to-treat analysis showed improvement of the DSQOLS score related to diet restrictions (week 24 – baseline difference, P = 0.008) and reduction of BMI (P = 0.003) and waist circumference (P = 0.002) in the intervention group compared with control subjects. No changes in HbA1c, fasting plasma glucose, daily insulin dose, and hypoglycemic episodes (<2.8 mmol/L) were observed. Per-protocol analysis, including only patients who continuously used carbohydrate counting and CSII during the study, confirmed improvement of the DSQOLS score and reduction of BMI and waist circumference, and showed a significant reduction of HbA1c (−0.35% vs. control subjects, P = 0.05). CONCLUSIONS: Among adult patients with type 1 diabetes treated with CSII, carbohydrate counting is safe and improves quality of life, reduces BMI and waist circumference, and, in per-protocol analysis, reduces HbA1c.
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For individuals with type 1 diabetes, intensive insulin therapy using the carbohydrate counting approach can result in improved glycemia.
“For individuals with type 1 diabetes, intensive insulin therapy using the carbohydrate counting approach can result in improved glycemia and is recommended.”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [267]
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- Authors
- Laurenzi, A., Bolla, A. M., Panigoni, G., Doria, V., Uccellatore, A., Peretti, E., Saibene, A., Galimberti, G., Bosi, E., & Scavini, M.
- Affiliations
- Vita-Salute San Raffaele University (IT)
- IRCCS Ospedale San Raffaele (IT)
- Corresponding author
- Bosi, Emanuele
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-03-21
- Volume
- 34
- Issue
- 4
- Pages
- 823-827
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3064035
- OpenAlex
- W2152872104
- Cited by
- 120
- References
- 23
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 9 · 2023: 12 · 2022: 8 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 5 · 2017: 6 · 2016: 9 · 2015: 7 · 2014: 9 · 2013: 14 · 2012: 4
- FWCI
- 7.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- carbohydrate counting, type 1 diabetes, insulin pump therapy, glycemic control, HbA1c, quality of life, body mass index, waist circumference, hypoglycemia, dietary restriction
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 1, Drug Administration Schedule, Female, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Quality of Life, Treatment Outcome, Infusions, Subcutaneous
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