Advanced carbohydrate counting allows adjustment of the prandial insulin dose for actual carbohydrate intake in T1DM patients on intensive insulin therapy. Carbohydrate counting is a meal planning approach used with clients who have diabetes that focuses on carbohydrate as the primary nutrient affecting postprandial glycemic response. Carbohydrates are a major determinant of postprandial blood glucose. Only insulin treatment is not enough to rely on, dietary adjustments also play an important role in the regulation of blood glucose. Type 1 diabetes mellitus (T1DM) is one of the most challenging medical disorders, and one of the key therapeutic goals to prevent or delay long-term diabetes complications in T1DM is the achievement and maintenance of near-normal glycemic control 1. Larger clinical trials are warranted to validate this positive impact. Carbohydrate counting may confer positive impact on glucose control. Subgroup analysis restricted to trials which compared carbohydrate counting with usual diabetes dietary found a significant decrease in HbA 1c in carbohydrate counting group (SMD: −0.68, 95%CI: −0.98 to −0.38, P = 0.000), and a similar result has emerged from six studies in adults (SMD: −0.40, 95%CI: −0.78 to −0.02, P = 0.037). Overall meta-analysis identified a significant decrease in HbA 1c concentration with carbohydrate counting versus other diabetes diet method or usual diabetes dietary education (SMD: −0.35, 95%CI: −0.65 to −0.05, P = 0.023).
Randomized controlled trials (RCTs) with at least 3 months follow-up that evaluated carbohydrate counting compared with usual or other diabetes dietary education in patients with T1DM were included. We searched PubMed, Embase, Web of Science, Cochrane Library and the Chinese Biology Medicine (CBM) up to December 2015. Our aim is to systematically assess the efficacy of carbohydrate counting in patients with T1DM. Potential benefits of carbohydrate counting for glycemic control in patients with type 1 diabetes mellitus (T1DM) remain inconclusive.
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