IMPACT OF CARBOHYDRATE COUNTING ON GLYCEMIC CONTROL IN CHILDREN WITH TYPE 1 DIABETES
- Sanjeev N. Mehta, MD, MPH (sanjeev.mehta{at}joslin.harvard.edu)1,
- Nicolle Quinn, MS, LD, RDN2,
- Lisa K. Volkening, MA1 and
- Lori M.B. Laffel, MD, MPH1
- 1 Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Boston, MA
- 2 Clinical and Translational Study Unit, Children's Hospital Boston, Boston, MA
Abstract
Objective: To study the association between parent carbohydrate counting knowledge and glycemic control in youth with type 1 diabetes (T1D).
Research design and methods: We assessed 67 youth ages 4-12 years with T1D≥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 standard deviation 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<.05). In a multivariate analysis (R2=.25, p=.007) adjusting for child age, gender and T1D duration, precision (p=.02) and more frequent blood glucose monitoring (p=.04), but not accuracy (p=.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 T1D.
Footnotes
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- Received November 17, 2008.
- Accepted February 17, 2009.
- Copyright © American Diabetes Association
