Revisão sistemática da efetividade e segurança da contagem de carboidratos no tratamento do diabetes mellitus tipo 1

Whether carbohydrate counting improves clinical outcomes in patients with type 1 Diabetes Mellitus (DM1) is still a matter of debate. Objective: We conducted a systematic review according to Cochrane methodology to evaluate effectivity and safe of carbohydrate counting in the management of DM1 patients. We included randomized studies that compared carbohydrate counting with general dietary advice in DM1 patients. Methods: Embase, Pubmed and BVS (Virtual Healthy Library) were used as our data sources. The primary outcomes were change in glycated haemoglobin (HbA1c), quality of life and episodes of severe hypoglycemia. The included trials were analyzed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: A total 3190 references were identified and two reviewers independently screened the titles and abstracts. From the 18 potentially eligible studies, six were included and 12 were excluded due to lack of randomization or different control groups. A pool of 650 patients was randomly assigned to intervention or control group. Only meta-analysis of HbA1c at 6 month (sub-groups analysis) showed a significant difference in favor of carbohydrate counting (SMD: -0.7 (-0.99, -0.41)). The meta-analysis of severe hypoglycemia, quality of life and long-term HbA1c did not show significantly differences between groups. Quality of evidence for severe hypoglycemia and change of long-term HbA1c was low and for quality of life was very low. Conclusion: exception for HbA1c at 6 month, the effectivity and safe of carbohydrate counting did not show to be significantly different from general dietary advice in DM1 patients ; Se a contagem de carboidratos melhora os desfechos clínicos dos pacientes com Diabetes Mellitus tipo 1 (DM1) é ainda uma questão controversa. Objetivo: Foi realizada uma revisão sistemática de acordo com a metodologia Cochrane para avaliar a efetividade e segurança da contagem de carboidratos no tratamento de pacientes com DM1. Foram incluídos estudos randomizados ...