Diabetes & metabolic syndrome · 2026
Effectiveness of education on carbohydrate counting (intervention) on HbA1c, cardio-metabolic profile and KAP (knowledge, attitude & practice) parameters among adults with type 1 diabetes.
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Gupta Lovely, Lal Priti Rishi, Gupta Yashdeep, Mani Kalaivani, Goyal Alpesh, Sati Hem Chandra, Seth Veenu, Tandon Nikhil
Аннотация
AIMS: Education pertaining carbohydrate counting can improve glycemic control but evidence on its effectiveness from South Asia is limited. This study evaluated the effectiveness of education on carbohydrate counting (intervention) in addition to usual care on key parameters of diabetes management among adults with type 1 diabetes (T1D).
METHODS: This single-centre, open-label, two-arm, parallel randomized controlled trial (RCT) enrolled 134 individuals with T1D between 18 and 40 years of age and with HbA1c of ≥7.5% at baseline. Participants were randomized in a 1:1 ratio to the Enhanced Usual Care (EUC) group (control arm) or Enhanced Usual Care focused on carbohydrate counting (EUC-CC) group (intervention arm). The primary outcome was the difference in proportions of individuals between the two groups who achieved HbA1c reduction of ≥0.5% from baseline at 6 months.
RESULTS: The participants had a mean (±SD) age of 25.3 (±5.7) years and HbA1c of 9.9 ± 1.8% (85 mmol/mol). A ≥0.5% reduction in HbA1c was observed in 75.8% of participants in the EUC-CC group compared to 60.9% in the EUC group (p = 0.081). EUC-CC group had additional HbA1c reduction [of 0.34 ± 0.27%; 95% CI (-0.87, 0.19), p = 0.210] compared to the EUC group. The participants in the EUC-CC group had a significantly greater increase in KAP scores by 5.3 ± 0.77 (4.01, 6.67), p < 0.001.
CONCLUSIONS: In this randomized controlled trial, both the groups showed significant improvement in HbA1c, while structured carbohydrate counting education resulted in favorable glycemic trends with significant improvements in knowledge, attitude and practice scores, suggesting potential behavioral benefits.
TRIAL REGISTRATION NUMBER: CTRI/2019/08/020793.
METHODS: This single-centre, open-label, two-arm, parallel randomized controlled trial (RCT) enrolled 134 individuals with T1D between 18 and 40 years of age and with HbA1c of ≥7.5% at baseline. Participants were randomized in a 1:1 ratio to the Enhanced Usual Care (EUC) group (control arm) or Enhanced Usual Care focused on carbohydrate counting (EUC-CC) group (intervention arm). The primary outcome was the difference in proportions of individuals between the two groups who achieved HbA1c reduction of ≥0.5% from baseline at 6 months.
RESULTS: The participants had a mean (±SD) age of 25.3 (±5.7) years and HbA1c of 9.9 ± 1.8% (85 mmol/mol). A ≥0.5% reduction in HbA1c was observed in 75.8% of participants in the EUC-CC group compared to 60.9% in the EUC group (p = 0.081). EUC-CC group had additional HbA1c reduction [of 0.34 ± 0.27%; 95% CI (-0.87, 0.19), p = 0.210] compared to the EUC group. The participants in the EUC-CC group had a significantly greater increase in KAP scores by 5.3 ± 0.77 (4.01, 6.67), p < 0.001.
CONCLUSIONS: In this randomized controlled trial, both the groups showed significant improvement in HbA1c, while structured carbohydrate counting education resulted in favorable glycemic trends with significant improvements in knowledge, attitude and practice scores, suggesting potential behavioral benefits.
TRIAL REGISTRATION NUMBER: CTRI/2019/08/020793.