The effect of carbohydrate counting on metabolic control in patients with type 1 diabetes mellitus

We aimed to investigate the effect of carbohydrate counting on metabolic and clinical parameters in patients with type 1 diabetes mellitus (DM) who were on flexible multiple daily insulin therapy. Nine volunteer adolescent patients using intensive insulin treatment (short acting insulin before meal plus two doses of long acting insulin (NPH) per day) were enrolled in the study. Clinical and metabolic parameters of these patients were retrospectively recorded from their files. The mean diabetes duration and age were 4.23±3.53 years and 15.45±1.47 years, respectively. Median HbA1C levels before and after carbohydrate counting were 9.26% and 8.26%, respectively. Total insulin dose, total cholesterol, HDL cholesterol and triglyceride levels were not different between before and after carbohydrate (CH) counting. However the LDL cholesterol levels decreased significantly with the treatment (p=0.036). The differences in the frequency of hypoglycemia and mean body mass index standard deviation scores were not significant before and after CH counting. The present study suggests that treatment with CH counting and two doses of intermediate-acting NPH plus short-acting insulin analogues may be an alternative treatment method for type 1 DM patients who are unable to use insulin pump due to financial problems also providing flexibility in meal-planning especially for adolescent type 1 DM patients.