Impact of Carbohydrate Counting on Glycemic Control in Children With Type 1 Diabetes
- Sanjeev N. Mehta, MD, MPH1,
- Nicolle Quinn, MS, LD, RDN2,
- Lisa K. Volkening, MA1 and
- Lori M.B. Laffel, MD, MPH1
- 1Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts;
- 2General Clinical Research Center, Children's Hospital Boston, Boston, Massachusetts.
- Corresponding author: Sanjeev N. Mehta, sanjeev.mehta{at}joslin.harvard.edu.
Abstract
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 ≥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 (R2= 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.
Footnotes
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
- Received November 17, 2008.
- Accepted February 17, 2009.
-
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
