Although counting carbohydrates is a widely recommended strategy for controlling blood sugar in type 1 diabetes mellitus (T1DM) patients, a recent review reports that the approach may not improve glycemic control much more than usual care.
The meta-analysis, published online on October 25, 2013, in The Lancet Diabetes & Endocrinology
, evaluated randomized trials that compared carbohydrate counting interventions with general or alternate advice in adults and children diagnosed with T1DM. A total of 7 studies with interventions lasting longer than 3 months were pooled and analyzed with a primary outcome of glycated hemoglobin (A1C) concentration.
Overall, there was no significant improvement in A1C concentration in patients who counted carbohydrates compared with those who received usual care. However, a subanalysis of 5 adult studies with a parallel design showed a modest 0.64% reduction in A1C among carbohydrate-counting patients compared with control patients.
The authors of the study conclude that more research is needed to investigate the efficacy of carbohydrate counting as well as other interventions to improve glycemic control in T1DM patients.
“It is possible that other methods of matching insulin with food are not being studied because of the belief that carbohydrate counting is a well-founded, evidence-based therapy,” they write. “Indeed, this meta-analysis shows the scarcity of high-level evidence.”