Can a virtual carbohydrate counting course improve glycaemia in people with type 1 diabetes? An observational study of data from the freestyle libre flash glucose monitoring system

ABSTRACT

Aims: To evaluate the effectiveness of an interactive virtual carbohydrate counting course on glycaemic indicators in people with type 1 diabetes. Methods: An observational study of glycaemic management following a virtual carbohydrate counting course, comprising of a weekly two hour session over three weeks on Microsoft Teams. Key metrics monitored from flash glucose monitoring (FGM) at baseline, three and six months time in range (TIR), time below range (TBR) estimated glycated haemoglobin (eHbA1c) and glucose variability (GV). A paired two sample for means T-test was used to determine statistical significance. Results: 26 participants completed the course (14 male, 12 female). Baseline and three month data was available for 17 participants (11 male, 6 female). Six month data was available for 14 participants, (9 male, 5 female). Significant improvements were observed at six months for GV (p = 0.05). No significant differences were observed at three months. Conclusions: One metric (GV) showed significant improvement at six months. The lack of significant improvements in other parameters and at three months could be related to many factors. There is a paucity of research on virtual carbohydrate counting courses for comparison purposes. The National Institute of Clinical Excellence (NICE) recommends offering structured education to all people with type 1 diabetes. The option of a virtual course has allowed for continuation of education during the covid-19 pandemic, which otherwise would have been absent. Further research is required to inform clinical practice and service development and provide further insight into lack of improvement in some parameters.