Effects of Carbohydrate Counting on Glycemic Control in
Type 1 Diabetes Patients: Clinical Experience in Thailand
Jindaporn Chaiyakhot MD*, Supaporn Somwang BSc, CDT**, Amornrat Hathaidechadusadee MSc, CDT**,
Chatvara Areevut MS, RD*, Sunee Saetung RN, MSc*, Nampeth Saibuathong APN***,
Ratanaporn Jerawatana APN***, Kanokporn Pabua RN****, Sirimon Reutrakul MD*
Affiliation :
* Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Division of Nutrition and Dietetics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
*** Division of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
**** Novo Nordisk Pharma (Thailand) Ltd., Bangkok, Thailand
Background : Carbohydrate counting has been shown to improve glycemic control in patients with Type 1 diabetes (T1D).
However, the data in Asians are lacking.
Objective : To explore the effects of carbohydrate counting in T1D patients in Thailand.
Material and Method: The present study was a retrospective medical charts review of adult T1D patients attending
carbohydrate counting clinic at Ramathibodi Hospital, Bangkok. Hemoglobin A1c (HbA1c), weight, and total daily insulin
dose (TDD) were collected. Patients’ self-reported hypoglycemia and satisfaction were assessed using questionnaires.
Results : Seventy-eight patients were included in this study. HbA1c significantly decreased from the baseline of 8.5±1.8%
to 8.0±1.8% at 3-month (mean difference (MD) -0.5%, p = 0.004), 8.1±1.7% at 6-month (MD -0.5%, p = 0.006), 8.1±1.7%
at 9-month (MD -0.5%, p = 0.003), and 8.1±1.8% at 12-month (MD -0.5% (p = 0.004). Compared to baseline, weight,
and TDD did not change significantly at 6-month (58.7±11.1 kg vs. 57.9±11.8 kg, p = 0.17; and 44.6±23.8 units/day vs.
42.3±22.5 units/day, p = 0.17). Patients reported that hypoglycemia decreased (p<0.001) while freedom in eating and
confidence in diabetes self-care increased (p<0.001).
Conclusion : Carbohydrate counting in Thailand significantly improved glycemic control with no increase in hypoglycemia,
along with increased satisfaction in T1D patients.
Keywords : Carbohydrate counting, Type 1 diabetes, Glycemic control, Hypoglycemia
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