TY - JOUR
T1 - Simplifying carb counting
T2 - A randomized controlled study – Feasibility and efficacy of an individualized, simple, patient-centred carb counting tool
AU - Witkow, Shulamit
AU - Liberty, Idit F.
AU - Goloub, Irina
AU - Kaminsky, Malka
AU - Otto, Olga
AU - Rabia, Yones Abu
AU - Boehm, Ilana Harman
AU - Golan, Rachel
N1 - Publisher Copyright:
© 2023 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - Introduction: The purpose of this study was to introduce and test a simple, individualized carbohydrate counting tool designed for persons with Type 1 Diabetes Mellitus (T1DM) in order to determine whether the tool improved A1C levels for participants with age, education or language barriers. Methods: In a randomized controlled trial, 85 participants were offered six diabetes instructional sessions free of charge over a six-month period. Forty-one received guidance using the regular carbohydrate counting (RCC) method. Forty-four received guidance using an individualized ‘Simple Carb Counting’ (SCC), involving two customized tables prepared for participants. Results: The simple, individualized SCC tool for carbohydrate counting was non-inferior to the standard method of RCC. The SCC tool was more effective among participants aged 40 and older, while no differences were found when comparing participants by education level. Irrespective of intervention group, all participants improved their A1C level (9.9% = 13.2 mmol/L vs 8.6% = 11.1 mmol/L, p =.001). A greater improvement in A1C level was seen in newly diagnosed participants (−6.1 vs −0.7, p =.005, −3.4 vs 0.9, p =.032) in both the RCC and SCC groups. All participants expressed improved emotional level per their PAID5 questionnaires (Problem Areas in Diabetes Scale-PAID), (10.6 (±5.7) vs 9.5 (±5.7), p =.023), with women reporting greater improvement than men. Conclusions: SCC is a simple, individualized, feasible, low-tech tool for carbohydrate counting, which promotes and enables accurate insulin dosing in people with T1DM. It was found more effective among participants aged 40 and older. Additional studies are needed to corroborate these findings.
AB - Introduction: The purpose of this study was to introduce and test a simple, individualized carbohydrate counting tool designed for persons with Type 1 Diabetes Mellitus (T1DM) in order to determine whether the tool improved A1C levels for participants with age, education or language barriers. Methods: In a randomized controlled trial, 85 participants were offered six diabetes instructional sessions free of charge over a six-month period. Forty-one received guidance using the regular carbohydrate counting (RCC) method. Forty-four received guidance using an individualized ‘Simple Carb Counting’ (SCC), involving two customized tables prepared for participants. Results: The simple, individualized SCC tool for carbohydrate counting was non-inferior to the standard method of RCC. The SCC tool was more effective among participants aged 40 and older, while no differences were found when comparing participants by education level. Irrespective of intervention group, all participants improved their A1C level (9.9% = 13.2 mmol/L vs 8.6% = 11.1 mmol/L, p =.001). A greater improvement in A1C level was seen in newly diagnosed participants (−6.1 vs −0.7, p =.005, −3.4 vs 0.9, p =.032) in both the RCC and SCC groups. All participants expressed improved emotional level per their PAID5 questionnaires (Problem Areas in Diabetes Scale-PAID), (10.6 (±5.7) vs 9.5 (±5.7), p =.023), with women reporting greater improvement than men. Conclusions: SCC is a simple, individualized, feasible, low-tech tool for carbohydrate counting, which promotes and enables accurate insulin dosing in people with T1DM. It was found more effective among participants aged 40 and older. Additional studies are needed to corroborate these findings.
KW - carbohydrate counting
KW - patient instruction
KW - type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85147535673&partnerID=8YFLogxK
U2 - 10.1002/edm2.411
DO - 10.1002/edm2.411
M3 - Article
C2 - 36750449
AN - SCOPUS:85147535673
SN - 2398-9238
VL - 6
JO - Endocrinology, Diabetes and Metabolism
JF - Endocrinology, Diabetes and Metabolism
IS - 2
M1 - e411
ER -