Parental carb-counting benefits diabetic child

Parental precision at carbohydrate counting is associated with improved blood sugar (glycemic) control in children with type 1 diabetes, according to a study published in the current issue of Diabetes Care.

Dr. Sanjeev N. Mehta of Harvard Medical School in Boston and colleagues interviewed the parents of 67 children with type 1 diabetes. The children were between 4 and 12 years old (average age, 9.1 years) with diabetes duration of at least 1 year (average duration, 4.1 years). Parents were asked to estimate the carbohydrate content of their child's meals during the previous 24 hours.

Overall, based on 182 parent interviews, the estimates of their children's carbohydrate consumption was 120 percent of the amount calculated using Nutrition Data System for Research (NDSR) software.

With accuracy defined as estimates within 20 percent of the actual carbohydrate intake, and precision defined as standard deviation values less than the 75th percentile, further analysis showed that lower A1C levels were significantly associated with precision and more frequent blood glucose monitoring, but not with accuracy, the researchers report.

A1C was 0.8 percent lower in children "whose parents demonstrated precision," according to the report. A1C is a frequently used test to measures how much glucose was bound to hemoglobin, the substance in the red blood cells that carries oxygen to the cells of the body, in the past 3 to 4 months. The A1C test is used as long-term measure of blood glucose control, which is associated with a lower risk of diabetes-related complications.

"Over the last 10 to 15 years, the adoption of new insulins and methods for insulin delivery (e.g., insulin pens and pump therapy) has facilitated diabetes care for youth with type 1 diabetes," Mehta said in an interview.

"Our findings suggest, however, that careful attention to meal-planning remains important for diabetes management... I hope that these findings highlight the importance of ensuring that families living with type 1 diabetes are properly educated in this area."

SOURCE: Diabetes Care, June 2009.