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Carbohydrate counting with a bolus calculator improves post-prandial blood glucose levels in children and adolescents with type 1 diabetes using insulin pumps
Pediatric Diabetes, 07/19/2012
Enander R et al. – The authors conclude that Carbohydrate counting (CC) using a bolus calculator may help decrease PG–fluctuations and increase post–meal PG values within target.
Methods- Forty patients with pump treatment, aged 13.8±3.4yr (range 5.0–19.5) and diabetes duration 8.0±3.8 (1.8–16.8) years completed a 1-yr multi-center study.
- HbA1c at start was 7.6±0.9% Diabetes Control and Complications Trial (DCCT), 59±10mmol/mol International Federation for Clinical Chemistry and Laboratory Medicine (IFCC).
- They were randomized into (A) control group, (B) manual CC, and (C) CC with a bolus calculator in the pump for calculations. (B) and (C) received education in CC while (A) received equal hours of traditional dietary education.
- Glucose meters were downloaded at visits and the standard deviation (PG-SD) calculated. PG measurements from before and 2 h after meals were registered separately.
- The authors found no difference in HbA1c between the groups.
- Group C had a non-significant decrease in PG-SD (p=0.056) compared to start, and a significantly higher number of post-meal PG between 4 and 8mmol/L at 12months compared to group A (55.3% vs. 30.6%, p=0.014).
- The frequency of hypoglycemia was reduced for the whole study group (p=0.01), but with no significant difference between groups. (A) significantly increased their basal-insulin dosage at 12months.
- In (C), all subjects wanted to continue CC after the study.