A scoping review exploring research investigating the influence of carbohydrate counting on eating behaviour and/or disordered eating in type 1 diabetes

Abstract

Aims

To evaluate evidence describing a potential association between carbohydrate counting (CC) in type 1 diabetes and eating behaviours and/or disordered eating behaviour (DEB).

Methods

Systematic literature searches were conducted using MEDLINE, Embase, PsycINFO, Web of Science, Scopus, and the trial register Cochrane Central Register of Controlled Trials.

Results

37 articles were eligible for review, 28 measured CC, 26 provided evidence of an association between CC and eating behaviours or participants’ relationship to food, and four provided evidence of an association between CC and disordered eating. Evidence suggests that patients using CC are less likely to score highly for DEB.

Conclusions

Measures of CC practise and adherence currently do not 1) consider the possible impact of the spectrum of CC strategies used within this cohort, which are often modified and personalised over time or, 2) consider that disordered eating in type 1 diabetes patients is often characterised by binge eating, restricted eating or insulin dose manipulation with inappropriate insulin-to-food calculations or the rejection of CC. Further research considering the range of insulin-to-food strategies practised and varying methods of CC education (particularly in early childhood), would be valuable in ascertaining associations between CC adherence and DEB.