Efficacy of carbohydrate counting in people with type 1 and type 2 diabetes mellitus: a systematic review and meta-analysis.

IF 1.2 Q4 ENDOCRINOLOGY & METABOLISM

Diabetology International Pub Date : 2025-04-10 eCollection Date: 2025-07-01 DOI:10.1007/s13340-025-00810-4

Naoki Sakane, Masayuki Domichi, Akiko Suganuma

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引用次数: 0

Abstract

Background: Although carbohydrate counting (CC) being the recommended dietary strategy for achieving glycemic control in people with diabetes, there is limited evidence. Our aim is to systematically assess the efficacy of CC in people with diabetes.

Methods: We searched PubMed up to October 2024 and assessed randomized controlled trials of interventions longer than 12 weeks in people with diabetes. Change in glycated hemoglobin (HbA1c) levels was the primary outcome. The results of clinically and statistically homogenous studies were pooled and meta-analyzed using the random-effects model to provide estimates of the efficacy of CC.

Results: We identified 16 studies (633 children and 640 adults) in type 1 diabetes mellitus (T1DM) and 6 studies (966 adults) in type 2 diabetes mellitus (T2DM). There was significant improvement in HbA1c levels with CC versus the other diets in T1DM (- 0.21%, 95% CI - 0.41 to - 0.01; p = 0.042) with large heterogeneity (I2 = 85.2%) in people with T1DM. In subgroup analyses, advanced CC (ACC) showed improved HbA1c levels (- 0.47%, 95% CI - 0.78 to - 0.15; p = 0.004) in adults with T1DM, but ACC did not in children with T1DM (- 0.07%, 95% CI - 0.25 to 0.10; p = 0.419). The effects of basic CC (BCC) on glycemic control for children with T1DM were not significant. Additionally, BCC did not show improved HbA1c levels in in adults with T2DM.

Conclusions: For glycemic control in people with T1DM, CC was an effective option. Although BCC was not effective for glycemic control in adults with T2DM, further high-quality and long-term studies are needed to confirm these issues.

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碳水化合物计数对1型和2型糖尿病患者的疗效：一项系统回顾和荟萃分析。

背景：虽然碳水化合物计数（CC）是糖尿病患者实现血糖控制的推荐饮食策略，但证据有限。我们的目的是系统地评估CC对糖尿病患者的疗效。方法：我们检索PubMed至2024年10月，评估干预时间超过12周的糖尿病患者的随机对照试验。糖化血红蛋白（HbA1c）水平的变化是主要结局。使用随机效应模型对临床和统计上均质研究的结果进行汇总和荟萃分析，以估计cc的疗效。结果：我们确定了16项1型糖尿病（T1DM）研究（633名儿童和640名成人）和6项2型糖尿病（T2DM）研究（966名成人）。与其他饮食相比，CC组在T1DM患者的HbA1c水平有显著改善(- 0.21%,95% CI - 0.41至- 0.01；p = 0.042)， T1DM患者异质性较大（I2 = 85.2%）。在亚组分析中，晚期CC （ACC）显示HbA1c水平改善(- 0.47%,95% CI - 0.78至- 0.15；p = 0.004)，但在T1DM儿童中没有(- 0.07%,95% CI - 0.25 ~ 0.10；p = 0.419)。基础CC （BCC）对T1DM患儿血糖控制的影响不显著。此外，成年T2DM患者的BCC未显示HbA1c水平的改善。结论：对于T1DM患者的血糖控制，CC是一种有效的选择。虽然BCC对成人T2DM患者的血糖控制没有效果，但需要进一步的高质量和长期研究来证实这些问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.