Carbohydrate counting with an automated bolus calculator helps to improve glycaemic control in children with type 1 diabetes using multiple daily injection therapy : An 18-month observational study
Articolo
Data di Pubblicazione:
2014
Citazione:
Carbohydrate counting with an automated bolus calculator helps to improve glycaemic control in children with type 1 diabetes using multiple daily injection therapy : An 18-month observational study / I. Rabbone, A.E. Scaramuzza, M.G. Ignaccolo , D. Tinti, S. Sicignano, F. Redaelli, L. De Angelis, A. Bosetti, G.V. Zuccotti, F. Cerutti. - In: DIABETES RESEARCH AND CLINICAL PRACTICE. - ISSN 0168-8227. - 103:3(2014 Jan 03), pp. 388-394. [Epub ahead of print]
Abstract:
AIMS: This study aimed to investigate the effect of carbohydrate counting (carbC), with or without an automated bolus calculator (ABC), in children with type 1 diabetes treated with multiple daily insulin injections.
METHODS: We evaluated 85 children, aged 9-16 years, with type 1 diabetes, divided into four groups: controls (n=23), experienced carbC (n=19), experienced carbC+ABC (n=18) and non-experienced carbC+ABC (n=25). Glycated haemoglobin (HbA1c), insulin use, and glycaemic variability - evaluated as high blood glucose index (HBGI) and low blood glucose index (LBGI) - were assessed at baseline and after 6 and 18 months.
RESULTS: At baseline, age, disease duration, BMI, HbA1c, insulin use, and HBGI (but not LBGI; p=0.020) were similar for all groups. After 6 months, HbA1c improved from baseline, although not significantly - patients using ABC (according to manufacturer's recommendations) HbA1c 7.14±0.41% at 6 months vs. 7.35±0.53% at baseline, (p=0.136) or without carbC experience HbA1c 7.61±0.62% vs. 7.95±0.99% (p=0.063). Patients using ABC had a better HBGI (p=0.001) and a slightly worse LBGI (p=0.010) than those not using ABC. ABC settings were then personalised. At 18 months, further improvements in HbA1c were seen in children using the ABC, especially in the non-experienced carbC group (-0.42% from baseline; p=0.018).
CONCLUSIONS: CarbC helped to improve glycaemic control in children with type 1 diabetes using multiple daily injections. ABC use led to greater improvements in HbA1c, HBGI and LBGI compared with patients using only carbC, regardless of experience with carbC.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Bolus calculator; Carbohydrate counting; Childhood diabetes; Education; Insulin therapy; Type 1 diabetes
Elenco autori:
I. Rabbone, A.E. Scaramuzza, M.G. Ignaccolo , D. Tinti, S. Sicignano, F. Redaelli, L. De Angelis, A. Bosetti, G.V. Zuccotti, F. Cerutti
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