Aims: To introduce a simple carb counting tool (CC) in patients with type 1 diabetes mellitus (T1DM) making CC easy and accessible, overcoming barriers such as age, education, gender or tutoring language.
Methods: In a randomized control trial 82 patients (pts.) received either 1-the common CC guidance using calculation of insulin sensitivity (IS), Carb:insulin ratio (C:I) or 2- a simple personalized tool consisting of 2 tables: A) correction values derived from the individual's IS, B) calculated insulin dose for carb content (personal C:I) for the most consumed carbs derived from the individual’s personal food diary. The intervention comprised 6 tutoring visits to a dietician, diabetes educator. The primary outcome was Hba1c post training.
Results: On the common tool were 39 pts. and 43 on the simple tool. Both groups showed significant statistical and clinical improvement; A1C declined -1.31% in the common tool and -1.59% in the simple method. The positive effects of CC using either method were unaffected by gender (-1.65% vs. -1.22% in males and females respectively P=0.43). We hypothesized that older age, language barrier or people with <12 years of education would benefit more from the simple tool compared to the common tool but no significant difference was found. Moreover, no significance was found among lower vs. higher education (>12 ys) (-1.32% vs. -1.64% respectively p=0.58). Newly diagnosed T1DM (≤1 year) in both groups had a significant decrease in HbA1c (-4.67%) compared to T1DM > 1 year (-.87%) (p<0.001). As expected, better compliance decreased the HbA1c. Those attending ≤ 2 meetings decreased by -.46% vs. -1.56% (p=0.051) in those attending 3-6 CC training sessions.
Discussion: CC was beneficial for all pts.; barriers such as age, gender, tutoring or spoken language didn’t hinder the benefits. Teaching CC close to diabetes diagnosis yielded better clinical results emphasizing the importance of early CC education. Our method provides an additional effective tool to better deliver patient -centered diabetes education.
S. Witkow: None. I.F. Liberty: Other Relationship; Self; AstraZeneca, Novo Nordisk Inc., Sanofi. I. Goloub: None. M. Kaminsky: None. O. Otto: None. Y. Abu Rabia: None. I. Harman Boehm: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Merck Sharp & Dohme Corp., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk Inc., Novo Nordisk Inc., Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novartis AG, Sanofi.