Efectividad del conteo de hidratos de carbono para el control metabólico de niños con diabetes mellitus tipo 1: revisión sistemática

Carbohydrate counting as a therapeutic intervention in patients with Diabetes Mellitus type 1 (DM1) plays an important role in obtaining an optimal postprandial glucose level, which is demonstrated with the correct levels of glycosylated haemoglobin (HbA1c). However, recommendations for children with DM1 are based on narrative reviews of the available evidence. Our objective was to evaluate the effectiveness of carbohydrate counting on metabolic control of children with DM1. This study was a systematic review. The search was conducted in PubMed, Google Scholar, and controlled trials of the Cochrane collaboration (CENTRAL), published from January 2000 to September 2015. Five eligible trials out of 261 potentially relevant studies were identified, which include two trials. The quality of the studies was generally poor. The two studies included agreed on the positive impact of carbohydrate counting in reducing HbA1c levels as a measure of metabolic control. In general, the other parameters measured showed conflicting results with no significant differences, except for the high density lipoprotein in one study, higher in the intervention group. Although carbohydrate counting is a promising technique for metabolic control in children with type 1 diabetes, the evidence found in this review is not enough to recommend it.