The effects of a carbohydrate counting program on self-management behaviors to hemoglobin A1C (HbA1c) remission control in patients with type 2 diabetes

Abstract

This quasi-experimental study employed a two-group pretest-posttest design to examine behavioral scores for hemoglobin A1C (HbA1c) control among patients with type 2 diabetes mellitus (T2DM) and the achievement of diabetes remission after receiving a 14-week carbohydrate counting program. The study sample consisted of 88 T2DM patients with HbA1c levels between 6.5% and 10.0% from a community hospital in Roi Et Province. Participants were divided into an experimental group (n=44) and a control group (n=44). The intervention tools included a carbohydrate counting program (content validity index=1.00) and a behavior assessment tool for HbA1c control (content validity index=0.89; reliability=0.81). Data were analyzed using paired sample t-test, independent t-test, Wilcoxon Signed Ranks Test, Mann-Whitney U test, and McNemar Test. The results were as follows: (1) the experimental group had significantly higher post-intervention behavioral scores than their pre-intervention scores (p<0.05, 95% CI=-19.01-16.85) and the control group (p<0.05, 95% CI=9.13-11.65); (2) the experimental group demonstrated significantly lower post-intervention HbA1c levels than both their pre-intervention levels and the control group (p<0.05); and (3) a significantly greater proportion of participants in the experimental group achieved diabetes remission (HbA1c<6.5%) after the intervention (p<0.001), accounting for 72.73% of the group. These findings suggest that the carbohydrate counting program is an effective intervention for improving self-management behaviors and achieving diabetes remission in patients with T2DM without the need for pharmacological treatment.