Assessment and Evaluation of Effectiveness of Carbohydrate Counting Method and Standard Diabetic Diet on Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus

Abstract

Abstract: Background: Carbohydrate counting is a meal-planning approach for individuals on a basalbolus insulin regimen, which helps with insulin dose adjustments based on the amount of carbohydrate intake in Type 1 Diabetes Mellitus. it is a chronic endocrine disorder requiring lifelong insulin therapy. Good glycemic control is needed to prevent complications and support normal growth in children and adolescents. Another dietary approach, the standard diabetic diet, follows fixed meal plans with constant carbohydrate distribution. A study has been planned to evaluate the effectiveness of these two approaches to identify the most suitable strategy for improving metabolic control in children and adolescents with T1DM. Methods: A study was conducted with 100 subjects randomized equally in two groups (control group n=50, intervention group n=50) aged 6 to 18 years. The intervention group used the carbohydrate-counting method while the control group followed a standard diet for 6 months. Data collected anthropometric measurements, biochemical profiles (fasting and post-prandial blood glucose), and 24 hr dietary recall, and daily insulin requirements were recorded at baseline and after the intervention at the 3rd month and 6 months for both groups. For data analysis and interpretation, descriptive statistics and Parametric tests were used. Results: The demographic variables of both groups had comparable baseline characteristics. The intervention group showed a significant reduction in mean HbA1c levels from 9.6 ± 2.0 to 8.5 ± 1.3 (P = 0.0124), along with a decrease in bolus insulin requirement, while no change was observed in the control group. The intervention and control groups showed a decrease in fasting and post-meal blood glucose levels; it was more pronounced in the study group, but not statistically significant. Conclusion: This study provides evidence that the carbohydrate counting method is effective in managing Type 1 Diabetes Mellitus in children. The intervention group showed a significant improvement in HbA1c levels. These findings highlight the importance of individualised nutrition therapy in managing Type 1 Diabetes in paediatric patients.