Abstract
BackgroundThe importance of achieving and maintaining an appropriate metabolic control in patients with type 1 diabetes mellitus (DM1) has been established in many studies aiming to prevent the development of chronic complications. The carbohydrate counting method can be recommended as an additional tool in the nutritional treatment of diabetes, allowing patients with DM1 to have more flexible food choices. This study aimed to evaluate the influence of nutrition intervention and the use of multiple short-acting insulin according to the carbohydrate counting method on clinical and metabolic control in patients with DM1.MethodsOur sample consisted of 51 patients with DM1, 32 females, aged 25.3 ± 1.55 years. A protocol of nutritional status evaluation was applied and laboratory analysis was performed at baseline and after a three-month intervention. After the analysis of the food records, a balanced diet was prescribed using the carbohydrate counting method, and short-acting insulin was prescribed based on the total amount of carbohydrate per meal (1 unit per 15 g of carbohydrate).ResultsA significant decrease in A1c levels was observed from baseline to the three-month evaluation after the intervention (10.40 ± 0.33% and 9.52 ± 0.32%, respectively, p = 0.000). It was observed an increase in daily insulin dose after the intervention (0.99 ± 0.65 IU/Kg and 1.05 ± 0.05 IU/Kg, respectively, p = 0.003). No significant differences were found regarding anthropometric evaluation (BMI, waist, hip or abdominal circumferences and waist to hip ratio) after the intervention period.ConclusionsThe use of short-acting insulin based on the carbohydrate counting method after a short period of time resulted in a significant improvement of the glycemic control in patients with DM1 with no changes in body weight despite increases in the total daily insulin doses.
Highlights
Diabetes mellitus (DM) is considered a major public health issue because of its increasing prevalence and high morbidity and mortality
This study aimed to evaluate the influence of nutrition intervention on the clinical and metabolic parameters in patients with DM1, using multiple dose of short-acting insulin according to the carbohydrate counting method
Subjects and Methods This study was conducted in outpatients with DM1 followed up at Pedro Ernesto University Hospital [Hospital Universitário Pedro Ernesto] (HUPE), diagnosed according to the American Diabetes Association (ADA) criteria [10], aged 10-60 years
Summary
Diabetes mellitus (DM) is considered a major public health issue because of its increasing prevalence and high morbidity and mortality. A study conducted by Moss et al, with individuals with DM1 followed up for 10 years, showed positive association between glycated hemoglobin levels and coronary artery disease [7]. Based on these facts, the American Diabetes Association (ADA) [8] emphasizes the importance of a good glycemic control to prevent chronic diabetes complications and suggests that changes in the diet composition of patients with DM are relevant strategies to achieve an appropriate metabolic control. The importance of achieving and maintaining an appropriate metabolic control in patients with type 1 diabetes mellitus (DM1) has been established in many studies aiming to prevent the development of chronic complications. This study aimed to evaluate the influence of nutrition intervention and the use of multiple short-acting insulin according to the carbohydrate counting method on clinical and metabolic control in patients with DM1
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