Type 1 diabetes (T1DM) is the most common chronic disease in young adults and children, which is treated with insulin, usually given as basal and boluses. Carbohydrate counting (CHOC) helps patients to determine the correct meal doses. The aim of this review is to study the effect of CHOC on glucose control, body weight, insulin dose and quality of life (QoL). The literature search was conducted using PubMed from January 2010 to October 2022. Studies included in this review are limited to randomized controlled studies involving an intervention group undergoing CHOC and a control group following the usual practice, measuring glycosylated hemoglobin (HbA1c) as a parameter of glucose control and involving only T1DM subjects. A total of ten articles were found to fulfill the criteria involving 1034 patients. Most of the studies showed a positive impact of CHOC on glucose control, especially in adults, where five out of six studies were statistically positive. However, in pediatrics, only two out of four showed a positive outcome. In all four studies using mobile applications, CHOC was better at controlling glucose. No difference was seen between the CHOC group and the control regarding the risk of severe hypoglycemia. In fact, two studies have shown lower hypoglycemia rates. No change in weight was observed in most of the studies (six out of eight). In subjects with T1DM, CHOC might provide better glucose control than traditional care without a significant increment in severe hypoglycemia or weight gain. Mobile application-based models showed promising results in glucose control.

Objective: To evaluate the effectiveness and safety of a mobile application for carbohydrate counting and bolus calculation (CHOC-BC) in adults with type 1 diabetes mellitus (T1DM). Research Design and Methods: A 12-week randomized controlled trial was conducted at King Fahad Medical City, Riyadh, Saudi Arabia. Adults with T1DM on multiple daily insulin injections and using Libre 2 glucose monitors were randomized to either CHOC-BC or conventional treatment. The primary endpoint was time in range (TIR; 70–180 mg/dL). Results: A total of 127 participants (70 females) were included: 64 in the intervention group and 63 in the control group with a mean age of 26.56 ± 4.8 and 26.74 ± 6.52 years, respectively. After 3 months, the intervention group achieved better TIR than the control group (51.20% ± 11.61% vs. 46.17% ± 13.02%; mean difference [MD], 5.03; 95% confidence interval [CI], 0.70–9.36; P = 0.023). Application users showed a significant reduction in level 2 time above range (17.25% ± 11.61% vs. 24.10% ± 15.74%; MD, −6.85; 95% CI, −11.70 to −1.99; P = 0.006). No significant differences were observed in body weight or time below range. Conclusions: The CHOC-BC mobile application empowered users to achieve better glycemic control while maintaining a safe profile that avoids hypoglycemia and weight gain.