Lower Daily Carbohydrate Intake Is Associated With Improved Glycemic Control in Adults With Type 1 Diabetes Using a Hybrid Closed-Loop System

Diabetes Care. 2020 Dec;43(12):3102-3105. doi: 10.2337/dc20-1560. Epub 2020 Sep 30.

Abstract

Objective: To assess the association between daily carbohydrate (CHO) intake and glycemic control in adult hybrid closed-loop (HCL) users with type 1 diabetes (T1D).

Research design and methods: Mean individual daily CHO intake (MIDC) and relative deviation from MIDC (≤80% low, 81-120% medium, >120% high CHO consumption) were compared with parameters of glycemic control assessed by continuous glucose monitoring.

Results: Records from 36 patients (26 male, 10 female; age 36.9 ± 13.5 years; HbA1c 7.1 ± 0.9% [54 ± 10 mmol/mol]) provided 810 days of data (22.5 ± 6.7 days per patient). Time in range (70-180 mg/dL) for low, medium, and high CHO consumption was 77.4 ± 15.4%, 75.2 ± 16.7%, and 70.4 ± 17.8%, respectively (P < 0.001). Time above range (>180 mg/dL) was 20.1 ± 14.7%, 22.0 ± 16.9%, and 27.2 ± 18.4%, respectively (P < 0.001). There was no between-group difference for time in hypoglycemia (<70 mg/dL; P = 0.50).

Conclusions: Daily CHO intake was inversely associated with glycemic control in adults with T1D using an HCL system. Lower CHO intake may be a strategy to optimize glucose control in HCL users.

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring / instrumentation
  • Blood Glucose Self-Monitoring / methods
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / diet therapy
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diet, Carbohydrate-Restricted*
  • Eating / physiology
  • Female
  • Glycemic Control / methods*
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced
  • Hypoglycemic Agents / administration & dosage
  • Insulin / administration & dosage*
  • Insulin Infusion Systems*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin

Associated data

  • figshare/10.2337/figshare.12962561