Uso de aplicativos para contagem de carboidratos como ferramenta de auxílio no autogerenciamento do diabetes mellitus tipo 1: uma revisão sistemática

Abstract

Aplicativos para a contagem de carboidratos (CCHO) contribuem com inúmeras possibilidades no apoio ao tratamento de pessoas com diabetes, auxiliando na terapia nutricional. Contudo, existe uma quantidade escassa de estudos que avaliam o uso dessa tecnologia, tornando de grande valia identificar seus possíveis benefícios. O presente estudo teve como objetivo verificar o uso de aplicativos para CCHO no autogerenciamento do tratamento do diabetes mellitus tipo 1 (DM1). Trata-se de uma revisão sistemática, realizada mediante pesquisa nas plataformas MedLine, LILACS, Portal de Periódicos CAPES e EBSCOhost, com artigos publicados no período de 2011 a 2021, pesquisados entre abril e junho de 2021, com descritores “Diabetes Mellitus, Type 1” and “Carbohydrate count” and “Mobile Apps”. Foram incluídos estudos originais do tipo ensaio clínico randomizado e excluídos artigos não-originais, estudos realizados com gestantes e pacientes com diabetes mellitus tipo 2. Inicialmente, foram encontrados 67 artigos publicados na íntegra, dos quais, após a remoção de duplicados, restaram 60. Após a aplicação dos critérios de elegibilidade, restaram dois estudos, com a população entre 12 e 46 participantes e tempo de intervenção em torno de 90 e 104 dias. Os aplicativos utilizados foram iSpy e VoiceDiab. Dentre os principais desfechos, destacam-se a melhora da precisão da CCHO, redução da hemoglobina glicada e maior tempo no alvo. Portanto, é possível concluir que o uso de aplicativos para a CCHO está associado a diversos benefícios, devido a sua estimativa mais precisa das quantidades de CHO, corroborando com melhor controle glicêmico.

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

“…As for the use of apps and the food scale, using specific and nonspecific CC apps and using the food scale to do the CC, when eating something different than usual and to make culinary recipes was associated with having adequate HbA1c in this study. Using mobile apps and food scales helps to perform CC more accurately and frequently, optimizing glycemic control and reducing counting errors (49)(50)(51). In the study by Trawley et al (52), the use of apps among people with T1DM to perform CC was associated with a lower self-reported HbA1c value and a higher frequency of glucose monitoring, corroborating the result found in the present study.…”

“…In the systematic review by Dantas et al. ( 50 ) it was concluded that the use of CC applications contributes to better glycemic control in patients with T1DM, which is confirmed with the reduction of HbA1c.…”

“…No studies were found that evaluated these variables either, however, it is assumed that with the creation and improvement of new technologies, such as mobile applications for CC, patients are able to perform the necessary calculations more easily, not needing to apply the concept at the time of use. In the systematic review by Dantas et al (50) it was concluded that the use of CC applications contributes to better glycemic control in patients with T1DM, which is confirmed with the reduction of HbA1c.…”

Covid-19 Pandemic and Its Metabolic, Glycemic and Weight-Stature Impacts on Children and Adolescents With Dm1

“…A study with Iranian adolescents showed a diet rich in fat and sodium pattern, mainly in obese boys, with lower consumption of trans fatty acids, saturated fatty acids, and sodium being recommended (ROUHANI et al, 2023). A systematic review explored applications for counting carbohydrates, what corroborated an improvement in the glycemic profile (DANTAS et al, 2023). These facts can be used in complementary nutritional consultation.…”

“…The 2019 Coronavirus (COVID- 19) pandemic has infected million of people worldwide and affected the entire population, including children (ages [5][6][7][8][9][10][11][12] and adolescents (ages [13][14][15][16][17] who, in late April 2020, made the transition to remote learning after school closures. This fact, added to socio-behavioral adaptations, such as social distancing and quarantine, has impacted this population's daily activities and lifestyle (BATES et al, 2020; IRWIN et al, 2022).…”