Author(s): Harvey J.

Source: Diabetic Medicine; Mar 2019; vol. 36 ; p. 109

Publication Date: Mar 2019

Publication Type(s): Conference Abstract

Available  at Diabetic Medicine –  from Wiley Online Library Full Collection

Abstract:Aims: To assess the impact of carbohydrate counting on weight and HBA1C for those with long-standing diabetes. Method(s): An audit was carried out to determine HBA1C and weight change following the provision of carbohydrate counting. Carbohydrate counting education was either delivered as a group or on a 1:1 basis. This education aimed to enable patients to adjust their bolus insulin using an insulin-to-carbohydrate ratio and an insulin sensitivity factor. Education was provided by a diabetes dietitian and a diabetes specialist nurse. This audit included those diagnosed with diabetes >1 year before carbohydrate counting, who learned to carbohydrate count from October 2017. Only those with HBA1C data before and after carbohydrate counting were included. Result(s): 20 patients (19 with Type 1 diabetes and 1 with Type 2 diabetes) had HBA1C review data available. Mean length of time with diabetes prior to carbohydrate counting was 12 years. 17 (85%) had a reduction in HBA1C, mean HBA1C change was-7mmol/mol (from 77mmol/mol to 70MMOL/MOL), on average three months following carbohydrate counting. Excluding those who were underweight, had a diagnosed eating disorder or had an unreliable weight due to kidney disease or pregnancy, 11 had weight data available for comparison, 7 (64%) lost weight despite a reduced HBA1C. Mean weight change was-0.35kg. Conclusion(s): For those that are appropriate, offering carbohydrate counting in long-standing diabetes can lead to a reduction in HBA1C. This audit found that despite an improvement in HBA1C, weight was not negatively affected.

Database: EMBASE