Assessment of Carbohydrate Counting Counseling in the Type 2 Diabetic Patients
Abstract
Background and objectives: Carbohydrate counting in the nutritional counseling for diabetic patients has been deployed in Mahasarakham Hospital for one year. The purpose of this study was to evaluate the food consumption and blood sugar levels of type 2 diabetic patients, who had received carbohydrate counting counseling in the diabetes clinic at Mahasarakham Hospital.
Methods: This was a cross-sectional descriptive research design 127 type 2 diabetic patients from diabetic clinic of Mahasarakham Hospital were studied. A validated questionnaire was used to collect information about knowledge and food consumption in relation to carbohydrate counting. Fasting blood sugar (FBS) and HbA1C data were extracted from their hospital records. The target variables for evaluating the benefits of carbohydrate counting were clinically desirable changes in food consumption practices and blood sugar levels. Differences in food consumption before and after one year of carbohydrate counting counseling were analyzed using the z-test, and differences in blood sugar levels were analysed using the paired t-test. Multiple logistic regression was used to identify factors affecting food consumption as carbohydrate counting target.
Results: The results showed that 66.1% of the patients participating in the survey were females, and the mean age of the subjects was 49.9 years (SD=6.0). The mean time since the diagnosis of diabetes mellitus was 6.1 years (SD=3.5). The mean number of carbohydrate counting counseling sessions received over the one-year period was 2.4 times (SD=0.5). There was a significant increase (p<0.010) in the percentage of subjects whose food consumption was consistent with the goals of carbohydrate counting. Although a significant decrease (p<0.001) in FBS levels was observed, there was no difference in the levels of HbA1c. In the multiple logistic regression, food consumption consistent with carbohydrate counting goals was found to be positively associated with knowledge about carbohydrate counting (ORadj3.46, 95%CI = 1.01-11.89).
Conclusions: The findings of this study support the benefits of using carbohydrate counting as a nutritional counseling technique of the type 2 diabetic patients. Knowledge of information related to carbohydrate counting is an important factor in its successful use.
Keywords: food consumption, blood glucose, type 2 diabetes, carbohydrate counting