Carbohydrate counting implementation on pediatric type 1 diabetes mellitus: systematic review and meta-analysis.

IF 2.8 Q3 ENDOCRINOLOGY & METABOLISM

Annals of Pediatric Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-09-19 DOI:10.6065/apem.2244242.121

Lowilius Wiyono, Nida Ghitha, Dina Clarisa, Anjani Larasati

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Abstract

Purpose: Type 1 diabetes mellitus, which is the most common type of diabetes among children, is not curable but can be managed well without a negative effect on quality of life. One of the treatments of type 1 diabetes mellitus is carbohydrate counting. This systematic review and meta-analysis sought to evaluate the efficacy of carbohydrate counting with regard to hemoglobin A1c (HbA1c) reduction in children with type 1 diabetes mellitus.

Methods: Nine studies were assessed, with the primary outcome being glycemic control (HbA1c changes). We searched the following electronic databases: ProQuest, PubMed, Scopus, and ScienceDirect. The quality of studies included was assessed using the risk of bias for randomized control trials and the JBI Critical Appraisal Checklist for observational and cross-sectional studies. Quantitative analyses were made and extrapolated into a forest plot.

Results: A total of 1,693 articles were identified. Four reviewers independently screened titles and abstracts. Of the 36 articles screened, 34 articles were found to be eligible. Of these, 25 studies were excluded because of unsuitable outcomes and study designs. Nine articles were included in the final analysis. Meta-analysis showed that there was a reduction in HbA1c in the carbohydrate counting group as compared to the control group. The cumulative effect of carbohydrate counting on HbA1c was a mean difference of -0.55 (95% confidence interval, -0.81 to -0.28, P<0.001). All of the studies exhibited similar results with the mean difference reduction favoring the interventional group. However, the heterogeneity analysis revealed an I2 value of 88%, implying high heterogeneity in the meta-analysis.

Conclusion: The meta-analysis showed evidence favoring the use of carbohydrate counting in the management of type 1 diabetes mellitus.

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儿童1型糖尿病碳水化合物计数的实施：系统综述和荟萃分析。

目的：1型糖尿病是儿童中最常见的糖尿病类型，虽然无法治愈，但可以很好地控制，不会对生活质量产生负面影响。1型糖尿病的治疗方法之一是碳水化合物计数。这项系统综述和荟萃分析旨在评估碳水化合物计数对1型糖尿病儿童血红蛋白A1c（HbA1c）降低的疗效。方法：对9项研究进行评估，主要结果是血糖控制（HbA1c变化）。我们搜索了以下电子数据库：ProQuest、PubMed、Scopus和ScienceDirect。纳入的研究质量使用随机对照试验的偏倚风险和观察性和横断面研究的JBI关键评估清单进行评估。进行了定量分析，并推断为森林地块。结果：共鉴定出1693篇文章。四位评审员独立筛选标题和摘要。在筛选的36篇文章中，有34篇符合条件。其中，25项研究因结果和研究设计不合适而被排除在外。最后分析了九篇文章。荟萃分析显示，与对照组相比，碳水化合物计数组的HbA1c有所降低。碳水化合物计数对HbA1c的累积影响为-0.55（95%置信区间，-0.81至-0.28，P）。结论：荟萃分析显示有证据支持在1型糖尿病的治疗中使用碳水化合物计数。

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

Annals of Pediatric Endocrinology & Metabolism Multiple-

CiteScore

4.00

自引率

18.20%

发文量

审稿时长

24 weeks

期刊介绍： The Annals of Pediatric Endocrinology & Metabolism Journal is the official publication of the Korean Society of Pediatric Endocrinology. Its formal abbreviated title is “Ann Pediatr Endocrinol Metab”. It is a peer-reviewed open access journal of medicine published in English. The journal was launched in 1996 under the title of ‘Journal of Korean Society of Pediatric Endocrinology’ until 2011 (pISSN 1226-2242). Since 2012, the title is now changed to ‘Annals of Pediatric Endocrinology & Metabolism’. The Journal is published four times per year on the last day of March, June, September, and December. It is widely distributed for free to members of the Korean Society of Pediatric Endocrinology, medical schools, libraries, and academic institutions. The journal is indexed/tracked/covered by web sites of PubMed Central, PubMed, Emerging Sources Citation Index (ESCI), Scopus, EBSCO, EMBASE, KoreaMed, KoMCI, KCI, Science Central, DOI/CrossRef, Directory of Open Access Journals(DOAJ), and Google Scholar. The aims of Annals of Pediatric Endocrinology & Metabolism are to contribute to the advancements in the fields of pediatric endocrinology & metabolism through the scientific reviews and interchange of all of pediatric endocrinology and metabolism. It aims to reflect the latest clinical, translational, and basic research trends from worldwide valuable achievements. In addition, genome research, epidemiology, public education and clinical practice guidelines in each country are welcomed for publication. The Journal particularly focuses on research conducted with Asian-Pacific children whose genetic and environmental backgrounds are different from those of the Western. Area of specific interest include the following : Growth, puberty, glucose metabolism including diabetes mellitus, obesity, nutrition, disorders of sexual development, pituitary, thyroid, parathyroid, adrenal cortex, bone or other endocrine and metabolic disorders from infancy through adolescence.