Abstract

Background: Carbohydrate counting has been shown to improve glycemic control in patients with Type 1 diabetes (T1D).
However, the data in Asians are lacking.

Objective: To explore the effects of carbohydrate counting in T1D patients in Thailand.

Material and Method: The present study was a retrospective medical charts review of adult T1D patients attending
carbohydrate counting clinic at Ramathibodi Hospital, Bangkok. Hemoglobin A1c (HbA1c), weight, and total daily insulin
dose (TDD) were collected. Patients’ self-reported hypoglycemia and satisfaction were assessed using questionnaires.

Results: Seventy-eight patients were included in this study. HbA1c significantly decreased from the baseline of 8.5±1.8%
to 8.0±1.8% at 3-month (mean difference (MD) -0.5%, p = 0.004), 8.1±1.7% at 6-month (MD -0.5%, p = 0.006), 8.1±1.7%
at 9-month (MD -0.5%, p = 0.003), and 8.1±1.8% at 12-month (MD -0.5% (p = 0.004). Compared to baseline, weight,
and TDD did not change significantly at 6-month (58.7±11.1 kg vs. 57.9±11.8 kg, p = 0.17; and 44.6±23.8 units/day vs.
42.3±22.5 units/day, p = 0.17). Patients reported that hypoglycemia decreased (p<0.001) while freedom in eating and
confidence in diabetes self-care increased (p<0.001).

Conclusion: Carbohydrate counting in Thailand significantly improved glycemic control with no increase in hypoglycemia,
along with increased satisfaction in T1D patients.