Last updated September 2, 2026
Key finding
The change from baseline was -40.4 mg/dl in the simple algorithm group (P < 0.0001).
This study compared the effectiveness of carbohydrate counting and a simple algorithm for insulin adjustment in managing Type 2 diabetes. Both methods showed improvements in A1C levels, but the differences were not statistically significant.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study compared the effectiveness of carbohydrate counting and a simple algorithm for insulin adjustment in managing Type 2 diabetes. Both methods showed improvements in A1C levels, but the differences were not statistically significant.
Understanding effective methods for managing Type 2 diabetes is crucial for improving patient outcomes. This study provides insights into two practical approaches that can help patients achieve better blood sugar control, which is essential for reducing the risk of diabetes-related complications.
The study had a small sample size, which may limit the generalizability of the findings. No significant differences were found between the two interventions, indicating unclear effectiveness. The study did not measure long-term outcomes beyond 24 weeks.
Published in
Publication details and source links for this paper.
Richard MB, Mary J, Margaret AP, et al. Comparison of Insulin-to-Carbohydrate Ratio and Simple Algorithm for Insulin Adjustment in Type 2 Diabetes. Diabetes Care. 2008;31(7):1305-1310. doi:10.2337/dc07-2137
A1C levels at week 24 were 6.54% for carbohydrate counting and 6.70% for the simple algorithm.
69.2% of the carbohydrate counting group achieved A1C <7.0%, while 73.2% of the algorithm group did.
The mean A1C change from baseline to week 24 was -1.59% for carbohydrate counting and -1.46% for the simple algorithm.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Carbohydrate Counting, Simple algorithm for insulin adjustment and Change in aortic pulse wave velocity from baseline to week 24, Fasting Plasma Glucose (FPG), HbA1c, and 3 more.
This study contributes evidence to
Primary intervention
Carbohydrate Counting
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
11
Evidence pairs
1278
Related studies
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Related evidence
Evidence topic
Save evidence
Core evidence
The primary outcomes reported in this study.
Carbohydrate Counting → Change in aortic pulse wave velocity from baseline to week 24
Carbohydrate Counting → Change in aortic pulse wave velocity from baseline to week 24
Carbohydrate Counting → Fasting Plasma Glucose (FPG)
Carbohydrate Counting → Fasting Plasma Glucose (FPG)
Carbohydrate Counting → Proportion achieving HbA1c under 6.5%
Carbohydrate Counting → Proportion achieving HbA1c under 6.5%
Carbohydrate Counting → Proportion achieving HbA1c under 7.0%
Carbohydrate Counting → Proportion achieving HbA1c under 7.0%
Carbohydrate Counting → Severe hypoglycemia
Carbohydrate Counting → Severe hypoglycemia
Simple algorithm for insulin adjustment → Change in aortic pulse wave velocity from baseline to week 24
Simple algorithm for insulin adjustment → Change in aortic pulse wave velocity from baseline to week 24
Simple algorithm for insulin adjustment → Fasting Plasma Glucose (FPG)
Simple algorithm for insulin adjustment → Fasting Plasma Glucose (FPG)
Simple algorithm for insulin adjustment → Proportion achieving HbA1c under 6.5%
Simple algorithm for insulin adjustment → Proportion achieving HbA1c under 6.5%
Simple algorithm for insulin adjustment → Severe hypoglycemia
Simple algorithm for insulin adjustment → Severe hypoglycemia
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Carbohydrate Counting and Change in aortic pulse wave velocity from baseline to week 24, Carbohydrate Counting and Fasting Glucose.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies on Carbohydrate Counting
Contributes to Carbohydrate Counting evidence base.
All studies measuring Change in aortic pulse wave velocity from baseline to week 24
Measures Change in aortic pulse wave velocity from baseline to week 24 as a key outcome.
All studies measuring Fasting Glucose
Measures Fasting Glucose as a key outcome.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Carbohydrate Counting appears to lower HbA1c.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Simple algorithm for insulin adjustment appears to improve fasting plasma glucose (FPG).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Fasting Plasma Glucose (FPG)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Simple algorithm for insulin adjustment appears to lower HbA1c.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Carbohydrate Counting for change in aortic pulse wave velocity from baseline to week 24.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Change in aortic pulse wave velocity from baseline to week 24
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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