Adherence to Carbohydrate Counting Improved Diet Quality of Adults with Type 1 Diabetes Mellitus during Social Distancing Due to COVID-19

Abstract

To control glycemic variability in people with Type 1 diabetes mellitus (T1DM), it is essential to perform carbohydrate counting (CC), a strategy that ensures better quality of life for these patients. Thus, this study aims to analyze potential factors associated with adherence to CC in adults with T1DM during social distancing due to COVID-19 in Brazil. This was a single cross-sectional study carried out in July 2020. An online form was used to collect sociodemographic and economic data on the purchasing of supplies and food, as well as social distancing. The Chi-square test was performed with adjusted residuals analysis and a binomial logistic regression analysis (p < 0.05). Of 472 adults, 37.71% reported performing CC in the same frequency as before social distancing. There was an association between performance of CC and the type of city (p = 0.027), family income (p = 0.000), use of financial emergency aid (p = 0.045), type of insulin administration and glycemic monitoring (p < 0.000), and cooking more (p = 0.012). Participants who maintained or reduced consumption of ultra-processed foods were 0.62 times more likely to adhere to CC (OR 0.626, 95% IC: 0.419–0.935) and participants who cooked more were 1.67 times more likely to adhere to CC (OR 1.67, 95% CI: 1.146–2.447). There are still people with T1DM who did not know about and did not use CC method, which highlights the need for diabetes education.

Characteristics of carbohydrate counting practice associated with adequacy of glycated hemoglobin in adults with type 1 diabetes mellitus in Brazil

“…Uliana et al. ( 23 ) found in their study, with adults with T1DM, that having more than six meals a day was associated with not performing CC. Furthermore, Fortin et al.…”

“…However, in 2020, Uliana et al. ( 23 ) conducted an online survey with adults with T1DM and observed a high prevalence of female respondents (86.0%). The same occurred in the online survey conducted by Fortin et al.…”

“…The construction of the questionnaire was based on a preliminary study carried out by Uliana et al. ( 23 ), which aimed to analyze sociodemographic and treatment factors associated with adherence to the CC strategy by adults with T1DM during social distancing in the COVID-19 pandemic in Brazil.…”

Value of carbohydrate counting

“…Barriers include but are not limited to access to dietitians with real-world diabetes teaching experience, patient–provider communication, cultural comfort with the health care team, transportation to appointments, out-of-pocket costs for healthcare professional visits, access to healthy food options, ability to take time away from work and health-literacy and numeracy-literacy skills. Given the global audience of BMJ NPH, readers likely already recognise there is great variation across the globe concerning access to diabetes education and dietitians sufficiently trained in CC 11–13…”

“…Given the global audience of BMJ NPH, readers likely already recognise there is great variation across the globe concerning access to diabetes education and dietitians sufficiently trained in CC. 11–13 …”