765-P: Effects of an Advanced Carbohydrate Counting Course on Diet Composition in Insulin-Treated Type 2 Diabetes

Abstract

Background and Aim: Training in advanced carbohydrate counting improves glycemic control in type 1 diabetes and type 2 diabetes. We aimed to investigate, whether a course in advanced carbohydrate counting reduced intake of carbohydrates and glycemic index of carbohydrates in persons with basal-bolus insulin treated type 2 diabetes. Material and Methods: We conducted a 24-week open-label, randomized controlled study in 79 participants with basal-bolus insulin treated type 2 diabetes. Participants were randomized 1:1 into two groups. ABC group received 6-hour training in advanced carbohydrate counting and use of an automated bolus calculator. MC group also received 6-hour training in advanced carbohydrate counting but was trained in manual calculation of insulin bolus. Diet composition and intake of macronutrients were assessed at baseline, week 12 and week 24 using a validated electronic food frequencies questionnaire. Results: Baseline characteristics were similar between groups (mean age 62.5 ± 9.6 years, mean HbA1C 72 ± 11 mmol/mol, mean diabetes duration 18.7 ± 7.6 years, mean BMI 33 ± 6 kg/m2). Mean energy intake was significantly reduced in the ABC group from baseline to week 24 (P=0.03), primarily due to significantly reduced intake of carbohydrates in form of cereals (P=0.005). No significant changes in energy intake were seen in the MC group (P=0.62). Further, glycemic index of ingested carbohydrates was reduced significantly in the ABC group (P=0.03), but not in the MC group (P=0.09). As previously reported HbA1c had decreased significantly by 9.0 mmol/mol in both groups at week 24. There were no significant changes in BMI throughout the study. Conclusion: Advanced carbohydrate counting with the use of an automated bolus calculator may help to reduce energy intake and glycemic index of ingested carbohydrates in basal-bolus insulin treated type 2 diabetes. Disclosure M.B. Christensen: None. T.I. Halldorsson: None. A. Gotfredsen: None. E. Hommel: None. P. Gæde: None. S.F. Olsen: None. K. Nørgaard: Advisory Panel; Self; Abbott, Medtronic, Novo Nordisk A/S. Speaker's Bureau; Self; Bayer US, Medtronic, Roche Diabetes Care, Rubin Medical, Sanofi, Zealand Pharma A/S. Stock/Shareholder; Self; Novo Nordisk A/S. Funding Roche A/S