Carb Counting May Not Help Diabetics

[Northerner]

Counting carbohydrates is an accepted strategy among patients with type 1 diabetes for managing postprandial blood sugar levels, but high-quality studies showing the practice to be effective are limited, researchers reported.

A newly published meta-analysis that included six studies in adults and one in children found no significant improvement in HbA1cconcentrations overall in carb counters versus control- or usual care groups (-0.35% [-3.9 mmol/mol], 95% CI minus 0.70-0.06; P=0.096).

http://www.medpagetoday.com/Endocrinology/Diabetes/42610

Eh? They don't really explain what the alternatives are. What is 'standard care'? How does following a low-glycaemic diet substitute for carb-counting, surely you would use both to achieve good levels? Carb counting wouldn't help post-prandial spikes on a high-glycaemic diet, unless you paid particular attention to insulin dose timing. 🙄

 

[Pumper_Sue]

An assessment of the quality of the studies showed an average score of 7.6 on a 1 to 13 point scale. All seven studies used appropriate randomization strategies. but none had adequate intervention allocation concealment and none masked the intervention from the outcome assessor, the researchers noted.

As they only just scored over 50% in the quality of the studies perhaps bin it as best place for it.

The comments posted are very interesting to say the least 🙂

Not sure if the article is suggesting we all stick to exactly the same foods every day and just inject the same insulin if not carb counting and adjusting insulin

If they were quality studies then I dread to think what others would be classed as.

 

[Cleo]

What a load of rubbish. There is NO WAY I could go through pregnancy with some level of sanity if it wasn't for carb counting. End of.

 

[HelenM]

On the report of the research from the ADA conference linked to in the article, there are some comments from Katherine Bell, as to why she thought carb counting may not always work well .
What doesn't seem to have been mentioned is that J Brand Miller has also been involved in investigating the use of an insulin index rather than carb counting.
http://care.diabetesjournals.org/content/34/10/2146.full

 

[Northerner]

On the report of the research from the ADA conference linked to in the article, there are some comments from Katherine Bell, as to why she thought carb counting may not always work well .
What doesn't seem to have been mentioned is that J Brand Miller has also been involved in investigating the use of an insulin index rather than carb counting.
http://care.diabetesjournals.org/content/34/10/2146.full

Thanks for this Helen, very interesting and makes a lot of sense - a sort of GI, but for insulin. Difficult to apply in practice though, I would have thought. I think there is also a misconception that people use a carb count alone to determine insulin dose, whereas in reality (for me at least) it's just one factor I use. The carb count gives me the scale of the dose, but then this is modified according to the many other factors of lesser importance, plus intuition based on experience. For example, today I have had two eggs and two slices of toast, plus a yoghurt and dosed 8 units. On Monday I had the same meal exactly, but dosed 10 units. The amount of carbs has remained the same, but I have taken into account lots of other indicators which led me to reduce the dose from Monday by 20%.

 

[trophywench]

Thank God I do not live in the US.

 

[LeeLee]

As they only just scored over 50% in the quality of the studies perhaps bin it as best place for it.

The comments posted are very interesting to say the least 🙂

Not sure if the article is suggesting we all stick to exactly the same foods every day and just inject the same insulin if not carb counting and adjusting insulin

If they were quality studies then I dread to think what others would be classed as.

For a glossary of what the terms used in research papers mean (and to help work out the quality of the research), see the glossary of terms here:
http://www.nhs.uk/news/Pages/Newsglossary.aspx