ACCURACY OF CARBOHYDRATE COUNTING IN TYPE 1 DIABETES MELLITUS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Dietary behaviors impact health outcomes in patients with type 1 diabetes mellitus. OBJECTIVE: To determine the impact of accurately of counting carbohydrates on glycemic control and growth patterns in children with type 1 diabetes mellitus. Cross-sectional analysis of 100 children with type 1 diabetes mellitus aged 2 to 12 years who report carbohydrate counting as their dietary method. Patients will be enrolled during routine outpatient visits at Children's Hospital, Boston, Massachusetts. Relevant surveys and questionnaires will be completed at the time of enrollment. 24-hour dietary recalls will be performed by phone interview on 3 separate occasions for each patient enrolled in the study. Parent's assessments of carbohydrate content will be compared to computer analysis of the 24-hour dietary recall. The anticipated enrollment period will be 6 months. MAIN OUTCOME MEASURES: Assessment of carbohydrate content by parent and computer analysis of 24-dietary recall, hemoglobin A1c level, anthropometric data, insulin regimen and severe hypoglycemic reactions and relevant demographic data. RESULTS: As a group, parents' estimation of their child's carbohydrate intake will be compared to computer analysis of the same meals, expressed as a percentage (primary aim). Estimations will be categorized as "accurate" or "inaccurate" if they are within or deviate by greater than 25% of the computer analysis, respectively. Clinical variables and demographic variables will be incorporated into a logistic regression model to determine predictors of accuracy in carbohydrate counting. Finally, parents who are accurate and inaccurate will be compared on the basis of clinically relevant outcomes for their children with type 1 diabetes: HbA1c (measure of glycemic control), rates of severe hypoglycemia and body mass index (secondary aims).