Carbohydrate Counting in Adults With Type 1 Diabetes Treated With Continuous Subcutaneous Insulin Infusion

Clinical Assessment of Carbohydrate Counting in Adult Patients With Type 1 Diabetes Treated With Continuous Subcutaneous Insulin Infusion: a Randomized Controlled Study (GIOCAR)

The investigators postulate that carbohydrate (CHO) counting in adult patients with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII) may improve glycemic control, glycemic variability and quality of life.

This study was designed as a randomized, controlled (versus standard education), open, one-center trial. Patients in group 1 were taught carbohydrate counting to estimate insulin preprandial bolus, while the patients in group 2 followed standard education. Primary outcome (glycosylated hemoglobin, HbA1c) and secondary outcomes (fasting glucose, glycemic variability, insulin requirement, body mass index (BMI), waist circumference, quality of life) were measured at baseline, 3, and 6 months.

Inclusion Criteria:

• type 1 diabetes mellitus
• age 18-65
• continuous subcutaneous insulin infusion for at least 3 months

Exclusion Criteria:

• patients who have already been trained in carbohydrate counting
• known hypothyroidism not on replacement therapy
• renal disease (serum creatinine >1.4 mg/dl in females and >1.7 mg/dl in males)
• patients with celiac disease
• pregnancy
• serious diseases or disabilities which may interfere with study assessments