Impact of carbohydrate counting on glycemic control in children with type 1 diabetes.
OBJECTIVE
To study the association between parent carbohydrate counting knowledge and glycemic control in youth with type 1 diabetes.


METHODS
We assessed 67 youth ages 4-12 years with type 1 diabetes (duration >or=1 year). Parents estimated carbohydrate content of children's meals in diet recalls. Ratios of parent estimates to computer analysis defined carbohydrate counting knowledge; the mean and SD of these ratios defined accuracy and precision, respectively. A1C defined glycemic control.


RESULTS
Greater accuracy and precision were associated with lower A1C in bivariate analyses (P < 0.05). In a multivariate analysis (R(2)= 0.25, P = 0.007) adjusting for child age, sex, and type 1 diabetes duration, precision (P = 0.02) and more frequent blood glucose monitoring (P = 0.04), but not accuracy (P = 0.9), were associated with lower A1C. A1C was 0.8% lower (95% CI -0.1 to -1.4) among youth whose parents demonstrated precision.


CONCLUSIONS
Precision with carbohydrate counting and increased blood glucose monitoring were associated with lower A1C in children with type 1 diabetes.
Mehta
Sanjeev N
SN
Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts, USA. sanjeev.mehta@joslin.harvard.edu
Quinn
Nicolle
N
Volkening
Lisa K
LK
Laffel
Lori M B
LM
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003927:Diet, Diabetic; D004040:Dietary Carbohydrates / Q000378:metabolism*; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D015999:Multivariate Analysis; D015203:Reproducibility of Results
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D006442:Glycated Hemoglobin