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Message: <blockquote data-quote="KennyA" data-source="post: 2755991" data-attributes="member: 517579">Thanks for posting this rather unusual paper. The thing that first jumps out at me about that bit of research is this in the exclusions from test: low daily carbohydrate intake (defined as below 25 E% or <100 g/day).   That would exclude me and a lot of other folks. Given that it's often said that low carb proper starts at a level of under ~130g/day, what the research actually appears to be doing is seeing how well people with a significant carb intake manage to estimate their actual carb intake. In addition the sample size is small, and the individuals involved had an average diabetes duration of 16 years, a high HbA1c (63mmol/l - which must be some sort of an average, although I'd like to know how that was calculated) and nine out of ten were on some sort of medication(s) - eg 41 of 47 participants were on metformin. So - I would guess that few, if any, of these folks were on anything that we'd recognise as a low carb way of eating. So there are a number of potential confounders right there. However, the critical thing is that the paper says Total carbohydrate intake remained unchained (sic, presume they mean unchanged) during the intervention period, and we did not find any other dietary changes. I therefore don't find it in the least surprising that there was no change to HbA1c, regardless of how well or badly the study participants learned to estimate carbs.  It seems obvious to me that carb-counting of itself can't do anything about blood glucose levels unless the information is then used to reduce carb intake. It's a bit baffling that they infer that they sort of expected carb-counting itself to have some impact on blood glucose. My take would be that the study might demonstrate that teaching people with the characteristics of this group to carb count is pointless unless the information is then used to drive carb reduction.  No carb reduction, no reduction in HbA1c.  And to my mind to reduce carbs you really have to have some idea of how many you're actually eating.</blockquote>

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