The Benefits of Carbohydrate Counting in Type 1 Diabetes Mellitus : A Scoping Review

Abstract

Asupan karbohidrat merupakan penentu utama kestabilan kadar glukosa pasien dengan DM tipe 1. Carbohydrate counting sebagai teknik pengaturan diet pasien dengan DM tipe 1 diketahui memiliki fleksibilitas dalam kontrol glukosa darah melalui pengaturan jumlah asupan karbohidrat dan dosis insulin, namun tetap dibutuhkan pemahaman yang baik terkait praktik carbohydrate counting agar tercapai target kontrol glukosa darah. Tujuan: Artikel ini bertujuan mereview hasil penelitian sebelumnya terkait manfaat terhadap kontrol metabolik dan ukuran tubuh, serta bagaimana praktik pemberian edukasi terkait carbohydrate counting pada pasien Diabetes Melitus tipe 1. Diskusi: Carbohydrate counting memberikan dampak terhadap HbA1c, indeks massa tubuh, lingkar pinggang, kualitas hidup, dan kepuasan terhadap terapi yang diterima pada pasien Diabetes Melitus tipe 1. Pengaruh carbohydrate counting bergantung pada usia, pengaturan makanan yang dilakukan, kemampuan menghitung kebutuhan ideal insulin, pemberian edukasi dan kesiapan pasien dalam melakukan carbohydrate counting, dukungan keluarga serta intervensi tambahan yang diberikan untuk mendukung perbaikan kontrol metabolik. Penggunaan Automated Bolus Calculator (ABC) bersamaan dengan carbohydrate counting dan Food Insulin Index (FII) diperkirakan mampu mendukung efektivitas terapi Diabetes Melitus tipe 1. Kesimpulan: Carbohydrate counting dapat meningkatkan kontrol metabolik pasien Diabetes Melitus tipe 1 pada anak-anak, remaja maupun dewasa dan dapat memfasilitasi penurunan berat badan. Dibutuhkan penekanan edukasi berkelanjutan oleh registered dietisien menggunakan media dalam menentukan jumlah porsi, dosis insulin dan melibatkan orang tua untuk meningkatkan akurasi carbohydrate counting pada anak dan remaja. Kombinasi penggunaan Automated Bolus Calculator (ABC) dan Flexible Intensive Insulin Therapy (FIIT) dapat meningkatkan efektivitas penerapan carbohydrate counting pada terapi DM tipe 1.

Evaluation of carbohydrate counting knowledge among individuals with type 1 diabetes mellitus in Saudi Arabia: a cross-sectional study

“…13 However, CC is a complex skill that is subject to error among children and young adults with T1DM and their families. 16 Therefore, identifying opportunities to develop CC skills can improve interventions and achieve accurate CC by patients and improved glycaemic management. 16 Few studies have investigated CC knowledge among individuals with T1DM in SA.…”

“…16 Therefore, identifying opportunities to develop CC skills can improve interventions and achieve accurate CC by patients and improved glycaemic management. 16 Few studies have investigated CC knowledge among individuals with T1DM in SA. A pilot study conducted with 94 Emirati and Omani adults with diabetes showed low scores for knowledge of the carbohydrate content of foods.…”

“… 16 Therefore, identifying opportunities to develop CC skills can improve interventions and achieve accurate CC by patients and improved glycaemic management. 16 …”

“…A meta-analysis of randomised controlled trials showed evidence favouring the use of the CC method and a significant reduction in HbA1c levels compared with that of controls 13. However, CC is a complex skill that is subject to error among children and young adults with T1DM and their families 16. Therefore, identifying opportunities to develop CC skills can improve interventions and achieve accurate CC by patients and improved glycaemic management 16…”

The Impact of Using Carbohydrate Counting on Managing Diabetic Patients: A Review

“…Diabetes mellitus (DM) is a metabolic disorder characterized by elevated levels of blood glucose (BG) due to compromised insulin secretion, impaired insulin action, or a combination of both [ 1 ]. Based on the presence or absence of insulin, diabetes mellitus can be classified into two primary groups: type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) [ 2 ].…”