Effects of advanced carbohydrate counting guided by an automated bolus calculator in Type 1 diabetes mellitus (StenoABC): a 12‐month, randomized clinical trial

Abstract

People with Type 1 diabetes initiating advanced carbohydrate counting obtained significantly greater HbA reductions when guided by an automated bolus calculator (NCT02084498).

ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes

“…Mobile applications (apps) and digital games are useful tools to assist carbohydrate estimations . Bolus calculators, used in association with carbohydrate counting, can aid insulin dose calculations and may further improve glycemic control …”

Long-Term Adherence to Automated Bolus Calculators

“…These advanced blood glucose meters, also known as automated bolus calculators (ABCs), have been demonstrated to improve metabolic control and treatment satisfaction in adults with poorly controlled type 1 diabetes (T1D) in randomized studies of up to 12 months' duration. [1][2][3] However, patient behavior may be affected by study participation even when studies are conducted in a setting resembling routine clinical practice. 4 Therefore, to investigate adherence to ABC use in real-life conditions, we conducted a follow-up study of ABC use and metabolic control in previous StenoABC participants 12 month after study completion.…”

“…1 A total of 168 patients were enrolled (baseline HbA1c 9.0% ± 0.8%) and 130 completed the study. The main finding of the study was that patients who used an ABC (ABC group) achieved significantly greater reduction in HbA1c compared with patients who relied on mental calculations (MC group) (-0.5% vs −0.2%, P = .033).…”

“…These advanced blood glucose meters, also known as automated bolus calculators (ABCs), have been demonstrated to improve metabolic control and treatment satisfaction in adults with poorly controlled type 1 diabetes (T1D) in randomized studies of up to 12 months' duration. [1][2][3] However, patient behavior may be affected by study participation even when studies are conducted in a setting resembling routine clinical practice.4 Therefore, to investigate adherence to ABC use in real-life conditions, we conducted a follow-up study of ABC use and metabolic control in previous StenoABC participants 12 month after study completion.StenoABC was a 12-month, randomized, parallel group clinical study of the effects of advanced carbohydrate counting (ACC) guided by an ABC compared with unassisted ACC (ie, insulin bolus dose size determination based on mental calculations) in ACC-naïve adults with suboptimally controlled, MDI-treated T1D. 1 A total of 168 patients were enrolled (baseline HbA1c 9.0% ± 0.8%) and 130 completed the study.…”

Update of Diabetes UK Evidence‐Based Nutritional Guidelines for 2018: a celebration of two leading journals working together to improve nutritional science and dietetic care for people living with diabetes

“…Hommel et al . reported how the use of technology can help match insulin doses to carbohydrate intake with an automated bolus calculator; however, it is also known that carbohydrate is not the only nutrient that influences glycaemic responses, with Paterson et al . highlighting how the addition of protein to a 30‐g carbohydrate, negligible fat test meal decreased early glycaemia (0–60 min) but led to a greater risk later.…”