P-297: Low adherence to carbohydrate counting in type 1 diabetes: insights of a socioeconomic context in a tertiary care hospital in Brazil
R Manoel, A P Spina Chiocchetti Possa, M F Vanti Macedo Paulino, M ZorronAbstract
Introduction
Carbohydrate counting is the gold standard dietary strategy for improving glycemic control. However, its use assumes that families have basic math skills and adequate organization. In emerging countries such as Brazil, these factors may limit its implementation. Despite this, there is a lack of national data assessing real-world adherence to carbohydrate counting in this context.
Objectives
To assess the frequency of carbohydrate counting use among children and adolescents with type 1 diabetes followed in a tertiary care outpatient clinic.
Methods
Observational, retrospective study based on the analysis of a database of patients followed in a pediatric endocrinology outpatient clinic at a tertiary care hospital.
Inclusion criteria
Children and adolescents with a diagnosis of type 1 diabetes under regular follow-up at the service Variables analyzed: Use of carbohydrate counting (yes/no) and total number of patients followed Descriptive analysis was performed, with calculation of absolute and relative frequencies.
Results
Data from 207 patients were analyzed. Among them, 18 patients performed carbohydrate counting, while 189 did not use this strategy, corresponding to an adherence rate of 8.7% and 91.3% non-use. These findings indicate a low frequency of carbohydrate counting in the studied population. Possible associated factors include low family educational level, caregiver burden, limited health literacy, operational difficulties with the technique, lack of school-based institutional support, and limited access to trained professionals. Unlike studies from high-income countries, where carbohydrate counting is widely adopted, these results suggest a mismatch between international recommendations and the reality in Brazil.
Conclusions
Low carbohydrate counting use (<10%) suggests structural and socioeconomic barriers. Strategies must be adapted to real-world contexts, ensuring feasible, accessible care for families in Brazil.