Abstract
BACKGROUND: Although carbohydrate counting is a recommended method for managing diabetes, it is not widely used by patients with Type 1 diabetes mellitus. Aiming to emphasize the importance of this method, this study is aimed at quantitatively assessing the effectiveness of carbohydrate counting in reducing HbA1c levels in children and adolescents with Type 1 diabetes mellitus. METHODS: Studies published between January 1993 and August 2024 were selected from the EMBASE, PubMed Central (PMC), Wiley Online Library, and ScienceDirect, without language restrictions. The primary outcome was to evaluate the reduction in HbA1c, comparing children and adolescents with Type 1 diabetes mellitus who did or did not use carbohydrate counting. RESULTS: The results were synthesized through a meta-analysis of the absolute mean difference in HbA1c between the groups. Seven studies were included in the meta-analysis, involving a total of 599 individuals, with 276 in the control group and 323 in the intervention group. When compared to the control group, all carbohydrate counting methods resulted in a reduction in HbA1c. The variation ranged from -1.35% for the greatest reduction to -0.73% for the smallest reduction, with a final mean of -0.94% (95% CI: -1.13, -0.74). Subgroup analysis showed that the greatest reduction in HbA1c was observed in patients who were experienced in carbohydrate counting and used the automated bolus calculator. CONCLUSIONS: This study confirms the effectiveness of carbohydrate counting in reducing HbA1c levels in children and adolescents with Type 1 diabetes mellitus, reinforcing that even the basic form of this strategy represents a valuable and advantageous approach in the management of the disease.