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The role of carbohydrate counting in glycemic control and oxidative stress in patients with type 1 diabetes mellitus (T1DM)

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Abstract

Purpose

Oxidative stress is closely related to type 1 diabetes mellitus (T1DM), playing a key role in the pathogenesis of the disease and progression of complications. It is characterized by loss of equilibrium between oxidative factors and antioxidant protective mechanisms. Several markers have been used to assess both components of oxidative status; two of which are malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP).

Methods

We investigated glycated hemoglobin (HbA1c), lipid profile, MDA, and FRAP in 35 patients with T1DM, aged 2–23 years, at the end of two 4-month observational periods: period A: standard insulin dosing per meal, and period B: proper prandial insulin dosing based on the amount of carbohydrates contained in each meal.

Results

At the end of period B, (i) glucose control (HbA1c) was improved; (ii) oxidative stress, estimated by MDA, showed a tendency to decrease; and (iii) antioxidant capacity, estimated by FRAP, was significantly increased compared with that of period A. No significant differences were observed in the lipid profile of the patients between the two periods.

Conclusion

Proper insulin dosing based on carbohydrate counting (CC) may have an impact on the antioxidant defensive mechanisms of patients with T1DM through the attainment of a better glycemic profile. There are also indications that it may reduce MDA, an important biomarker of oxidative stress and a significant mediator of complications in T1DM. Therefore, prompt dietetic intervention using CC as early as possible after the diagnosis of T1DM is important for achieving optimal glycemic control and improved oxidative status.

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Authors and Affiliations

  1. Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, School of Medicine, University of Patras, 26504, Patras, Greece

    Eirini Kostopoulou, Ioulia Livada, Ioanna Partsalaki & Bessie E. Spiliotis

  2. Laboratory of Pharmacognosy and Chemistry of Natural Products, Department of Pharmacy, University of Patras, 26504, Patras, Greece

    Fotini Lamari

  3. Department of Medical Physics, School of Medicine, University of Patras, 26504, Patras, Greece

    Spyros Skiadopoulos

  4. Faculty of Health Sciences, Department of Nursing, University of Peloponnese, Tripoli, Greece

    Andrea Paola Rojas Gil

Authors
  1. Eirini Kostopoulou
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  2. Ioulia Livada
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  3. Ioanna Partsalaki
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  4. Fotini Lamari
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  5. Spyros Skiadopoulos
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  6. Andrea Paola Rojas Gil
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  7. Bessie E. Spiliotis
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Contributions

Eirini Kostopoulou and Bessie Spiliotis: conceptualization

Fotini Lamari, Spyros Skiadopoulos, Ioanna Partsalaki, and Andrea Paola Rojas Gil: methodology

Eirini Kostopoulou and Bessie Spiliotis: formal analysis and investigation

Eirini Kostopoulou: writing—original draft preparation

Bessie Spiliotis, Ioanna Partsalaki, Spyros Skiadopoulos, Fotini Lamari, and Andrea Paola Rojas Gil: writing—review and editing

Bessie Spiliotis: supervision

Corresponding author

Correspondence to Eirini Kostopoulou.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Committee of Ethics and Code of Conduct for Research of the University Hospital of Patras and with the 1964 Declaration of Helsinki and its later amendments, or comparable ethical standards. No reference number was needed for this specific data collection of the studied patients.

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Obtained from the parents of the patients involved and the patients.

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Kostopoulou, E., Livada, I., Partsalaki, I. et al. The role of carbohydrate counting in glycemic control and oxidative stress in patients with type 1 diabetes mellitus (T1DM). Hormones 19, 433–438 (2020). https://doi.org/10.1007/s42000-020-00189-8

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  • DOI: https://doi.org/10.1007/s42000-020-00189-8

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