Premium
Effects of advanced carbohydrate counting on glucose control and quality of life in children with type 1 diabetes
Author(s) -
Donzeau Aurelie,
Bonnemaison Elisabeth,
Vautier Vanessa,
Menut Vanessa,
Houdon Laure,
Bendelac Nathalie,
Bismuth Elise,
BouhoursNouet Natacha,
Quemener Emmanuel,
Baron Sabine,
Nicolino Marc,
Faure Nathalie,
Pochelu Sandra,
Barat Pascal,
Coutant Regis
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13076
Subject(s) - medicine , diabetes mellitus , metabolic control analysis , quality of life (healthcare) , type 1 diabetes , randomized controlled trial , population , type 2 diabetes , diabetes treatment , pediatrics , endocrinology , nursing , environmental health
Abstract Objective The effect of advanced carbohydrate counting (ACC) on metabolic and quality of life (QOL) outcomes is uncertain in children with type 1 diabetes. Our aim was to determine whether ACC would improve HbA1c and QOL scores as compared with standard nutrition in this population. Methods We randomized 87 patients using pump and rapid‐acting analogs in a 1 year randomized multicenter study (age 9.6 ± 3.5 years, diabetes duration 4.6 ± 2.7 years, HbA1c 7.8 ± 0.5% [62 ± 5 mmol/mol]). The ACC group received CC education and the control group received traditional dietary education. HbA1c was measured every 3 months. At 0 and 1 year, general, diabetes‐specific, and diet‐related QOL were respectively assessed by the KIDSCREEN and WHO‐5 questionnaires, the diabetes‐specific module of the DISABKIDS, and the diet restriction items of the DSQOLS. Results Mean HbA1c was lower in the ACC than the control group at 3 months ( P < .05) and tended to be lower at 6 months ( P = .10), 9 months ( P = .10), but not at 12 months. The mean of individual average HbA1c during the one‐year study period (from M3 to M12) was 7.63 ± 0.43 in the ACC vs 7.85 ± 0.47% in the control group (60 ± 5 vs 62 ± 5 mmol/mol)( P < .05). ACC was associated with significantly higher scores at 1 year on the KIDSCREEN children's psychological scale and the KIDSCREEN parents' physical scale, the DISABKIDS children's treatment scale, and the children's and parents' dietary restriction scales of the DSQOLS (indicating better QOL or lower perceived diet restriction). Conclusions ACC may be associated with small improvements in metabolic control and QOL scores in children.