Revista de la Facultad de Ciencias de la Salud (Dec 2014)
Carbohydrate counting for children with diabetes type 1
Abstract
Type 1 Diabetes Mellitus (DM1) is an endocrine disease with autoimmune bases that mainly affects children and adolescents. It is characterized by progressive loss of beta cells mass to a critical level where the ability to release the insulin, needed for the utilization of glucose by tissues, is affected, triggering microvascular damage, main long-term complication. Short-term complications are diabetic keto-acidosis and, secondary to insulin therapy, the hypoglycemia. Although insulin therapy is the mainstay of treatment, sometimes it is difficult to calculate the proper dosage for precise glycemic control; carbohydrate counting plays an important role here in the optimization of postprandial glycemic levels, which is demonstrated by the correct levels of glycosylated hemoglobin (HbA1c). This review seeks to assess the available scientific evidence on the effectiveness of carbohydrate counting in children with DM1. Search until May 2014 was conducted in PubMed, Trip database, Cochrane and academic Google; three clinical trials performed in individuals under 18 were found. The studies demonstrate effectiveness but the quality is not strong enough. No systematic reviews were found. A more exhaustive search and possibly more clinical trials are needed to be recommended as a technique of metabolic control of Type 1 Diabetes Mellitus in children.
