Objective: Advanced carbohydrate counting (CC), a nutritional intervention that adjusts insulin based on the estimated carbohydrate content of meals, has shown inconsistent effects on glycometabolic control. This study aimed to evaluate the long-term efficacy of advanced CC in patients with type 1 diabetes mellitus (DM) and assess adherence and consistency rates.
Materials and Methods: Adult patients diagnosed with type 1 DM who applied multiple dose insulin therapy were included. Data from patients who completed advanced CC training and practiced it for at least 3 months were retrospectively reviewed. Baseline demographic data, as well as BMI, HbA1c, lipid profile, daily insulin doses, meal frequency, hospital visits, and chronic complication rates, were evaluated before and after CC.
Results: Twenty-five patients (mean±SD age: 22.6±7.7 years, 68% female) were included. The duration of CC was a median (IQR) of 40 (12-75) months. HbA1c levels significantly improved (p=0.023), while BMIs and lipid parameters remained similar. Four patients experienced diabetic ketoacidosis in the year before starting CC and none during follow-up (p=0.046). None of the patients had new-onset diabetic complications during CC. The adherence rate was 69.5%, and the discontinuation rate was 32%. The primary reason for discontinuation was the difficulty in implementing the method daily.
Conclusion: Advanced CC is effective for improving glycemic control in patients with type 1 DM, with effects that last for a long time. Consistency may be hindered for some patients by difficulties integrating it into their daily life. Dietary and lifestyle advice should be individualized in patients with type 1 DM.