Due to the technology development, the diet habit has completely changed. It accompanied by the metabolite diseases relevant to blood glucose and lipids, which are dependent with the atherosclerosis and cardiovascular disease. In this study, we using matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/MS) to characterize triglycerides in human plasma. In the other, the glycosylated hemoglobin in human whole blood was detected by liquid electrospray laser desorption ionization (Liquid ELDI/MS). Triglycerides are energy source (9 kcal/g) in human body, derived from glycerol and three fatty acids. It is a main constituent of vegetable oil and animal fats. In clinical diagnosis, human plasma was mixed with triglyceride Kit to react to the final 520 nm UV-absorbing substance, then the concentration was quantified consistent with the calibration line by UV/Visible spectrometry. By the way, it needed Kit chemicals for one trial. MALDI-TOF/MS is a simple and easy method to operate to detect complex compounds in human plasma, only need to optimize the parameters (solvent collection, sample dilution, matrix selection, sample pretreatment ) to form a homogeneous crystals. The developed ¡§seed layer¡¨ method can reduce the sweet spot effect and cause a lower with-in spot variation (RSD < 20%) compared to ¡§premix¡¨ method (RSD >30%). Combined with statistic software 2D peak distribution, a semi-quantification can be observe of 24 different triglyceride concentration human plasmas. The level of glycosylated hemoglobin (HbA1c) in whole blood is currently the most important measurement of long-term control of the glycemic state of diabetes. As a result of the interferences of high concentrations of metabolites, proteins and salts in whole blood, tedious sample cleanup procedures must be performed prior to subjecting the sample solutions to conventional LC/MS and MALDI analyses for the detection of HbA1c. Electrospray laser desorption ionization mass spectrometry (ELDI/MS), a two-step ambient ionization technique, has been developed to characterize analytes directly from the liquid sample surface. One drop of the diluted hole blood (1/10, v/v in water) was placed on the stainless steel plate. The sample droplet was irradiated with a pulse laser, the desorbed analytes were post-ionized in an electrospray (ESI) plume (ESI solution: 70% methanol in water, 0.1% acetic acid), and the analyte ions were detected by a ion trap mass analyzer. Through this study, the protocol for efficiently characterizing HbA1c present in a drop of diluted whole blood with ELDI/MS was established. We successfully detected the ion signal of HbA1c with ELDI/MS. Quantification of the level of HbA1c in the whole blood of diabetic patients was achieved by calculating the ratio of the ion peak area of the glycosylated and non-glycosylated hemoglobin ions. A linear relationship exists for the quantitative results of HbA1c in whole blood of 20 diabetic patients obtained between ELDI/MS and that through conventional spectroscopic measurement.

published_or_final_version / Nursing Studies / Master / Master of Philosophy

Resumo: Objetivos: dois estudos prospectivos comparativos de intervenção foram realizados para avaliar o efeito do tratamento periodontal não-cirúrgico sobre parâmetros clínicos periodontais e imunológicos do fluido sulcular gengival e do plasma sanguíneo de pacientes com periodontite crônica portadores ou não de Diabetes mellitus Tipo 2. Material e Método: Vinte e três indivíduos com Diabetes mellitus Tipo 2 com controle metabólico inadequado e periodontite crônica (grupo diabetes) e 26 indivíduos sistemicamente saudáveis com periodontite crônica (grupo controle) foram avaliados quanto a parâmetros periodontais, marcadores inflamatórios do fluido sulcular gengival (interleucinas, metaloproteinases de matriz e atividade de elastase), marcadores inflamatórios no plasma sanguíneo (interleucinas, fator de necrose tumoral alfa, proteína C-reativa e fibrinogênio) e perfil lipídico, antes e após 3 meses do tratamento periodontal. Adicionalmente foi avaliada a influência do tratamento periodontal no controle glicêmico do grupo com diabetes. Resultados: houve redução significativa de todos os marcadores inflamatórios avaliados no fluido gengival, exceto a interleucina 18, após tratamento periodontal, associado a uma melhora da condição clínica periodontal em ambos os grupos. Sistemicamente, o grupo diabetes apresentou maiores níveis de proteina C reativa e triglicérides em ambos os períodos ao se comparar com o grupo controle. O tratamento periodontal foi efetivo em reduzir os níveis de TNF-_ e fibrinogênio no grupo diabetes. Houve melhora no controle glicêmico embora não significativa. Conclusão: os resultados do presente estudo sugerem que os pacientes portadores de Diabetes mellitus Tipo 2 com controle metabólico inadequado apresentam boa resposta ao tratamento periodontal nãocirúrgico, com redução de marcadores inflamatórios no fluido gengival. / Abstract: Objetive: Two prospective comparative interventional studies were performed in order to evaluate the effect of non-surgical periodontal therapy on periodontal clinical and immunological parameters in gingival crevicular fluid (CGF) and plasma of patients with chronic periodontitis with or without type 2 Diabetes mellitus (T2DM). Material and Method: Twenty three individuals with inadequately controlled T2DM and chronic periodontitis (diabetes group) and 26 systemically healthy individuals with periodontitis (control group) were assessed for clinical parameters, inflammatory biomarkers in GCF (interleukins, matrix metalloproteinases and elastase activity), circulating markers of inflammation (interleukins, tumor necrosis factor alpha, C-reactive protein and fibrinogen and lipid profile before and 3 months after periodontal therapy. Additionally, the influence of periodontal treatment on glycemic control was evaluated in the diabetes group. Results: There was a significant reduction of all inflammatory biomarkers in GCF after therapy, except for interleukin 18 levels, and it was associated with improvement on periodontal status in both groups. Systemically, the diabetes group showed high levels of C-reactive protein and triglycerides compared with the control group in both periods. The periodontal therapy was effective in reducing TNF-_ circulating and fibrinogen in the diabetes group. The treatment did not change the glycemic control significantly. Conclusion: The results of the present study suggest that patients with inadequately controlled T2DM present a good response to nonsurgical periodontal treatment, with reduction of inflammatory biomarkers in GCF. However, 3 months after therapy, its influence on systemic inflammatory condition is limited. / Orientador: Silvana Regina Perez Orrico / Coorientador: Carlos Marcelo S. Figueiredo / Banca: Adriana Campus Passanezi Sant'ana / Banca: Ricardo Guimarães Fischer / Banca: Elaine Maria Sgavioli Massucato / Banca: Joni Augusto Cirelli / Doutor

Objetivo: Determinar la relación entre el nivel de hemoglobina glicosilada y el riesgo de desarrollar diabetes mellitus tipo 2 en el plazo de diez años, en pacientes no diabéticos de un Hospital de Lima Norte. Metodología: El presente estudio fue descriptivo, observacional, transversal y prospectivo, se realizó en el consultorio externo de un Hospital de Lima Norte, participaron 101 personas no diabéticas entre 18 y 65 años de uno u otro sexo, y se relacionó los niveles de hemoglobina glicosilada con el riesgo de desarrollar diabetes mellitus tipo 2 en el plazo de diez años mediante el test de FINDRISK. Resultados: Se estudiaron 101 pacientes no diabèticos, el 66.7% fueron del sexo femenino, el grupo etario más frecuente fue los menores de 35 años, (44.1%). El 99% de los encuetados presentaron valores normales de hemoglobina glicosilada. Los resultados del test de FINDRISK mostraron que el 29.7% de los evaluados tuvieron riesgo bajo de desarrollar diabetes tipo 2 en el plazo de 10 años, y el 21.8% tuvieron riesgo de moderado y alto. Cuando se asoció hemoglobina glicosilada con el riesgo de desarrollar diabetes s mellitus tipo 2 no se encontró asociación p=0.218. Conclusión: No se halló relación estadísticamente significativa cuando se relacionó la hemoglobina glicosilada con los riesgos de desarrollar diabetes mellitus tipo 2, en la población estudiada. / Objective: To determine the relationship between the glycosylated hemoglobin level and the risk of developing type 2 diabetes mellitus within ten years in non-diabetic patients in a Hospital in North Lima. Methodology: This study was descriptive, observational, transversal, and prospective, and was carried out in the outpatient clinic of a Hospital in Lima Norte, 101 non-diabetic persons between 18 and 65 years of age from one sex or another, And glycosylated hemoglobin levels were associated with the risk of developing type 2 diabetes mellitus within ten years using the FINDRISK test. Results: 101 non-diabetic patients were studied, 66.7% were female, the age group was the most frequent ones under 35 years of age (44.1%). 99% of respondents had normal glycosylated hemoglobin values. Results of the FINDRISK test showed that 29.7% of those evaluated had a low risk of developing type 2 diabetes within 10 years, and 21.8% had moderate and high risk. When glycosylated hemoglobin was associated with the risk of developing type 2 diabetes Mellitus, no association was found p=0.218. Conclusion: No statistically significant relationship was found when glycosylated hemoglobin was associated with the risks of developing type 2 diabetes mellitus in the study population. / Trabajo de investigación

A crossover design study was conducted to determine if reducing pain, by using alternative sites off the finger tip, would increase testing frequency and improve clinical outcome as measured by glycosylated hemoglobin. Subjects with type I and type 2 diabetes tested with the FreeStyle alternative-site meter (group I) or tested with their original meter (group 2). After 3 months the subjects used the alternate meter. Testing frequency and blood glucose concentrations were recorded for the month before the study began and monthly thereafter. Glycosylated hemoglobin was tested initially, at the crossover point, and at study conclusion. Insulin users increased testing frequency from 2.4 to 3.0 tests per day. Testing frequency for non-insulin users remained the same at 1.5 tests per day. Testing frequency was essentially the same with the FreeStyle and the original meters. The average hemoglobin A1c was 7.4% (standard deviation 1.5%) initially, 7.3% (standard deviation 1.5%) at the crossover point, and 6.9% (standard deviation 1.1%) after 6 months. There was no significant difference in hemoglobin A1c measurements between meter types after 6 months. Thirteen months later a final hemoglobin A1c, testing frequency, and a questionnaire regarding meter preference and pain rating were obtained. Seventy-four percent of participants preferred the alternative-site meter, which was rated as significantly (p < .05) less painful. Testing frequency significantly improved (p = .001) while free strips were being provided. Testing frequency 13 months later was not significantly different from the baseline (p = .101). Hemoglobin A 1 c was significantly lower 6 months after the study began (p = .000) and 13 months later (p = .008) at baseline.

The purpose of this study was to determine whether adults with type 2 diabetes participating in American Diabetes Association (ADA) diabetes self-management education (DSME) randomly assigned to an intensive follow-up group (IFG), utilizing continuous glucose monitoring system (CGMS), or a standard follow-up group (SFG) have any significant differences in mean HgbA1c values and health belief scores over time. Baseline HgbA1c values and health beliefs were measured using the revised Expanded Health Belief Model (HBM) questionnaire. The questionnaire measured the 8 HBM domains: perceived susceptibility; severity; treatment benefit; cues to action; motivation; barriers; self-efficacy and structural elements. Twelve weeks after DSME, patients returned for follow-up based on random assignment. The SFG received routine follow-up care: HgbA1c measurements; behavioral goals and education assessments. The IFG received routine follow-up and CGMS. Patients wore the CSMS for 72 hours and recorded their daily food, blood glucose values, medications and physical activities. Results were analyzed and reviewed with patients. Both groups returned in 24 weeks for HgbA1c measurements and to complete the HBM questionnaire. A repeated measure ANOVA analysis showed a statistically significant reduction in mean HgbA1c at each time period (F=86.75. p>.0001 ) from week 1 to week 12 (SFG 8.6-7.1; IFG 8.5 --7.1,) and from week 12 to week 24 ( SFG 7.1 to 6.9; IFG 7.1 -- 7.0). There were no significant differences found between the groups. (F = 0.17 p > 0.87). Following DMSE and follow-up intervention some health belief scores improved but no significant differences were found between groups except for severity scores. (SFG 27.05, IFG 25.00, p=0.03). The power of the study to detect small differences between the groups was affected by the higher than anticipated attrition and the significant lowering of HgbA1c in the education arm of the study. Both groups achieved a high success rate (58% IFG; 55% SFG) to lower the HgbA1c to the ADA goal of less than 7. DSME and follow-up care (both standard follow-up and more intensive follow-up) achieved a significant lowering of HgbA1c (1.6%), which has been shown to reduce diabetes related morbidity and health costs.

Motivation Hypertension and type 2 diabetes mellitus are common in the black population of South Africa. The literature also shows that elevated blood glucose concentrations can lead to an increase in blood pressure and a blunted decline in nocturnal blood pressure. Therefore, the motivation for this study was to determine if blood glucose may play a role regarding the blunted nocturnal decline in blood pressure in African and Caucasian men. Aim The aim of this study was to investigate the relationship between a blunted nocturnal decline in blood pressure and blood glucose in African and Caucasian men. Methodology A comparative population study was preformed that consisted of 202 school teachers (101 African and 101 Caucasian) between the ages of 25–60 years from the North West Province, South Africa. Subjects were excluded if their body temperature was elevated, had a dependence or abuse of psychotropic substances, were regular blood donors and/or vaccinated in the previous three months. Ambulatory systolic (SBP) and diastolic blood pressure (DBP) were measured. Blood samples from the antebrachial vein were collected in sodium fluoride tubes to determine the serum glucose level and glycosylated hemoglobin A1c (HbA1c) percentage. Estimated average glucose (eAG) was determined from the percentage HbA1c by means of a regression formula. Means and proportions were compared by standard t–test and the chi–square test, respectively. Pearson correlations were used to determine unadjusted associations and multiple regression analysis to determine adjusted associations between variables. Results and Conclusion African men had an elevated HbA1c (p<0.001), eAG (p<0.001), nighttime SBP (p<0.001) and DBP (p<0.001). These results remained similar when non–dipping African and Caucasian men were compared. The Africans also smoked more (p=0.012), consumed more alcohol (p=0.049), had a higher percentage of non–dippers (p=0.054), HIV infected subjects (p<0.001) and a larger number of subjects that used anti–hypertensive medication (p=0.049). The unadjusted analysis showed positive correlations between all the blood pressure measurements and serum glucose, HbA1c and eAG in the African non–dipper men. While in the non–dipper Caucasian men, only daytime SBP and nighttime SBP (22:00–06:00) correlated positively with serum glucose, HbA1c and eAG. Furthermore, when viewing the relationship between carotid intima–media thickness (CIMT) and the blood pressure measurements in the African population, only nighttime (00:00– 04:00) SBP (r=0.581, p<0.001) and DBP (r=0.566, p<0.001) showed positive associations. After adjustments were made for age and body mass index the associations between the various blood pressure measurements and blood glucose disappeared in the non–dipper Caucasian men. However, in the non–dipper African men both nighttime (22:00–06:00) SBP and (00:00– 04:00) SBP showed positive correlations with serum glucose, HbA1c and eAG. After full adjustments (age, BMI, smoking, alcohol intake, physical activity, C–reactive protein and baroreceptor sensitivity) were made, nighttime (00:00–04:00) SBP was the only measure of blood pressure that correlated positively with HbA1c (p=0.069) and eAG (p<0.001) in the nondipper African men. No significant relationships were found for Caucasian men. Furthermore, to determine if the association between nighttime (00:00–04:00) SBP and eAG were independent of CIMT, we adjusted for CIMT. By doing so the positive association between SBP and eAG remained significant in the non–dipper African men (R2=0.617; =0.438; p=0.008) and nonsignificant in the non–dipper Caucasian men (R2=0.423; =0.169; p=0.33). However, the relationship between CIMT and eAG disappeared when we adjusted for SBP, suggesting that the SBP and eAG relationship drives CIMT. In conclusion, the association between the early morning SBP (00:00–04:00) and the blood glucose in non–dipping African men suggests that the blunted decline in nocturnal blood pressure during the early morning hours is associated with chronically elevated blood glucose. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2011.

Motivation Hypertension and type 2 diabetes mellitus are common in the black population of South Africa. The literature also shows that elevated blood glucose concentrations can lead to an increase in blood pressure and a blunted decline in nocturnal blood pressure. Therefore, the motivation for this study was to determine if blood glucose may play a role regarding the blunted nocturnal decline in blood pressure in African and Caucasian men. Aim The aim of this study was to investigate the relationship between a blunted nocturnal decline in blood pressure and blood glucose in African and Caucasian men. Methodology A comparative population study was preformed that consisted of 202 school teachers (101 African and 101 Caucasian) between the ages of 25–60 years from the North West Province, South Africa. Subjects were excluded if their body temperature was elevated, had a dependence or abuse of psychotropic substances, were regular blood donors and/or vaccinated in the previous three months. Ambulatory systolic (SBP) and diastolic blood pressure (DBP) were measured. Blood samples from the antebrachial vein were collected in sodium fluoride tubes to determine the serum glucose level and glycosylated hemoglobin A1c (HbA1c) percentage. Estimated average glucose (eAG) was determined from the percentage HbA1c by means of a regression formula. Means and proportions were compared by standard t–test and the chi–square test, respectively. Pearson correlations were used to determine unadjusted associations and multiple regression analysis to determine adjusted associations between variables. Results and Conclusion African men had an elevated HbA1c (p<0.001), eAG (p<0.001), nighttime SBP (p<0.001) and DBP (p<0.001). These results remained similar when non–dipping African and Caucasian men were compared. The Africans also smoked more (p=0.012), consumed more alcohol (p=0.049), had a higher percentage of non–dippers (p=0.054), HIV infected subjects (p<0.001) and a larger number of subjects that used anti–hypertensive medication (p=0.049). The unadjusted analysis showed positive correlations between all the blood pressure measurements and serum glucose, HbA1c and eAG in the African non–dipper men. While in the non–dipper Caucasian men, only daytime SBP and nighttime SBP (22:00–06:00) correlated positively with serum glucose, HbA1c and eAG. Furthermore, when viewing the relationship between carotid intima–media thickness (CIMT) and the blood pressure measurements in the African population, only nighttime (00:00– 04:00) SBP (r=0.581, p<0.001) and DBP (r=0.566, p<0.001) showed positive associations. After adjustments were made for age and body mass index the associations between the various blood pressure measurements and blood glucose disappeared in the non–dipper Caucasian men. However, in the non–dipper African men both nighttime (22:00–06:00) SBP and (00:00– 04:00) SBP showed positive correlations with serum glucose, HbA1c and eAG. After full adjustments (age, BMI, smoking, alcohol intake, physical activity, C–reactive protein and baroreceptor sensitivity) were made, nighttime (00:00–04:00) SBP was the only measure of blood pressure that correlated positively with HbA1c (p=0.069) and eAG (p<0.001) in the nondipper African men. No significant relationships were found for Caucasian men. Furthermore, to determine if the association between nighttime (00:00–04:00) SBP and eAG were independent of CIMT, we adjusted for CIMT. By doing so the positive association between SBP and eAG remained significant in the non–dipper African men (R2=0.617; =0.438; p=0.008) and nonsignificant in the non–dipper Caucasian men (R2=0.423; =0.169; p=0.33). However, the relationship between CIMT and eAG disappeared when we adjusted for SBP, suggesting that the SBP and eAG relationship drives CIMT. In conclusion, the association between the early morning SBP (00:00–04:00) and the blood glucose in non–dipping African men suggests that the blunted decline in nocturnal blood pressure during the early morning hours is associated with chronically elevated blood glucose. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2011.

Made available in DSpace on 2014-06-11T19:33:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-03-25Bitstream added on 2014-06-13T20:05:25Z : No. of bitstreams: 1 correa_fob_dr_arafo.pdf: 719555 bytes, checksum: 7ed0212e1fd2855b73aa40fa8cdc4f4f (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Objetivos: dois estudos prospectivos comparativos de intervenção foram realizados para avaliar o efeito do tratamento periodontal não-cirúrgico sobre parâmetros clínicos periodontais e imunológicos do fluido sulcular gengival e do plasma sanguíneo de pacientes com periodontite crônica portadores ou não de Diabetes mellitus Tipo 2. Material e Método: Vinte e três indivíduos com Diabetes mellitus Tipo 2 com controle metabólico inadequado e periodontite crônica (grupo diabetes) e 26 indivíduos sistemicamente saudáveis com periodontite crônica (grupo controle) foram avaliados quanto a parâmetros periodontais, marcadores inflamatórios do fluido sulcular gengival (interleucinas, metaloproteinases de matriz e atividade de elastase), marcadores inflamatórios no plasma sanguíneo (interleucinas, fator de necrose tumoral alfa, proteína C-reativa e fibrinogênio) e perfil lipídico, antes e após 3 meses do tratamento periodontal. Adicionalmente foi avaliada a influência do tratamento periodontal no controle glicêmico do grupo com diabetes. Resultados: houve redução significativa de todos os marcadores inflamatórios avaliados no fluido gengival, exceto a interleucina 18, após tratamento periodontal, associado a uma melhora da condição clínica periodontal em ambos os grupos. Sistemicamente, o grupo diabetes apresentou maiores níveis de proteina C reativa e triglicérides em ambos os períodos ao se comparar com o grupo controle. O tratamento periodontal foi efetivo em reduzir os níveis de TNF-_ e fibrinogênio no grupo diabetes. Houve melhora no controle glicêmico embora não significativa. Conclusão: os resultados do presente estudo sugerem que os pacientes portadores de Diabetes mellitus Tipo 2 com controle metabólico inadequado apresentam boa resposta ao tratamento periodontal nãocirúrgico, com redução de marcadores inflamatórios no fluido gengival. / Objetive: Two prospective comparative interventional studies were performed in order to evaluate the effect of non-surgical periodontal therapy on periodontal clinical and immunological parameters in gingival crevicular fluid (CGF) and plasma of patients with chronic periodontitis with or without type 2 Diabetes mellitus (T2DM). Material and Method: Twenty three individuals with inadequately controlled T2DM and chronic periodontitis (diabetes group) and 26 systemically healthy individuals with periodontitis (control group) were assessed for clinical parameters, inflammatory biomarkers in GCF (interleukins, matrix metalloproteinases and elastase activity), circulating markers of inflammation (interleukins, tumor necrosis factor alpha, C-reactive protein and fibrinogen and lipid profile before and 3 months after periodontal therapy. Additionally, the influence of periodontal treatment on glycemic control was evaluated in the diabetes group. Results: There was a significant reduction of all inflammatory biomarkers in GCF after therapy, except for interleukin 18 levels, and it was associated with improvement on periodontal status in both groups. Systemically, the diabetes group showed high levels of C-reactive protein and triglycerides compared with the control group in both periods. The periodontal therapy was effective in reducing TNF-_ circulating and fibrinogen in the diabetes group. The treatment did not change the glycemic control significantly. Conclusion: The results of the present study suggest that patients with inadequately controlled T2DM present a good response to nonsurgical periodontal treatment, with reduction of inflammatory biomarkers in GCF. However, 3 months after therapy, its influence on systemic inflammatory condition is limited.

Made available in DSpace on 2014-07-29T15:23:44Z (GMT). No. of bitstreams: 1 Dissertacao Final - Izabela Z de Albuquerque.pdf: 1038583 bytes, checksum: 13e3b77d98b69c764907a2844ac3318c (MD5) Previous issue date: 2012-05-10 / Objective: The aim of the study was evaluated the effect of carbohydrate counting, for four months, on anthropometric parameters, body composition, biochemical and food intake in adolescents with type 1 diabetes mellitus. Methods: Clinical trial, controlled and randomized study at the Clinic of Endocrinology, Hospital das Clinicas, Federal University of Goiás, with 28 patients divided into intervention group (IG - carbohydrate counting) and control (CG - no counting carbs) and monitored fortnightly. At the beginning and end of the study data were collected on: anthropometric (weight, height and waist circumference), body composition (skinfold thickness and subscapular), biochemical (fasting glucose - FPG, postprandial glucose - GPP, glycated hemoglobin - A1C, total cholesterol - TC, triglycerides - TG, high density lipoprotein - HDL-c and low density lipoprotein - LDL-c) and, fortnightly, 24-hour recalls. Statistical analysis was performed using the statistical package SPSS version 18.0. For categorical variables used the chi-square and Fisher exact test. Shapiro-Wilk test to assess the normality of continuous variables, paired t test or Wilcoxon test for intragroup analysis, and Student's t test or Mann-Whitney test for intergroup analysis. The significance level was 5%. Results: The CG increased A1C (p=0.024) and both groups decreased energy intake (CG: p=0.005; IG: p=0.002). IG decreased A1C (p=0.002), but increased the CT (p=0.009) and LDL-c (p=0.012). This group also increased the caloric intake of carbohydrates (p=0.005) and decreased caloric intake of fat (p=0.002). There were a decreased in FPG and A1C (p=0.033 and p<0.001, respectively) in IG and increased CT and LDL-c (p=0.004 and p=0.019, respectively). The mean capillary glucose pre-and post-prandial were not affected between groups (p>0.005), although the oscillation glucose was lower in IG. Conclusion: Carbohydrate counting resulted in improved glycemic control and glucose concentrations more constant. However, this practice was associated with increased CT and LDL-c. Patients who have applied this strategy increased the caloric intake of carbohydrates and decreased consumption of fat. / Objetivo: Avaliar o efeito da contagem de carboidratos, por quatro meses, sobre parâmetros antropométricos, de composição corporal, bioquímicos e de consumo alimentar de adolescentes portadores de Diabetes Melito tipo 1. Metodologia: Ensaio clínico, controlado, randomizado, realizado no Ambulatório de Endocrinologia do Hospital das Clínicas da Universidade Federal de Goiás, com 28 pacientes, divididos em grupo intervenção (GI - contagem de carboidratos) e controle (GC - sem contagem de carboidratos), e acompanhados quinzenalmente. Ao início e ao final do estudo foi feita avaliação antropométrica (peso, altura e circunferência da cintura), da composição corporal (pregas cutâneas tricipital e subescapular), bioquímica (glicemia de jejum - GJ, glicemia pós-prandial - GPP, hemoglobina glicada - A1C, colesterol total - CT, triglicerídeos - TG, lipoproteína de alta densidade - HDL-c e lipoproteína de baixa densidade - LDL-c) e, quinzenalmente, de consumo alimentar (recordatórios de 24 horas). A análise estatística foi procedida por meio do pacote estatístico SPSS versão 18.0. Para as variáveis categóricas utilizou-se o teste Qui-Quadrado e teste Exato de Fisher. Teste de Shapiro-Wilk para avaliar a normalidade das variáveis contínuas, teste t-pareado ou teste de Wilcoxon para análise intragrupo, e teste t de Student ou teste de Mann-Whitney para a análise intergrupo. O nível de significância adotado foi de 5%. Resultados: O GC aumentou a A1C (p=0,024) e ambos os grupos diminuíram o consumo calórico (GC: p=0,005; GI: p=0,002). GI diminuiu a A1C (p=0,002), mas aumentou o CT (p=0,009) e o LDL-c (p=0,012). Este grupo também aumentou o consumo calórico de carboidratos (p=0,005) e diminuiu o consumo calórico de lipídeos (p=0,002). Verificou-se a diminuição de GJ e A1C (p=0,033 e p<0,001, respectivamente) no GI e o aumento de CT e LDL-c (p=0,004 e p=0,019, respectivamente). As médias glicêmicas pré e pós-prandiais não foram afetadas entre os grupos (p>0,005), embora a oscilação glicêmica tenha sido menor no GI. Conclusão: A contagem de carboidratos resultou na melhora do controle glicêmico e em concentrações glicêmicas mais constantes. Entretanto, a sua prática esteve associada ao aumento de CT e LDL-c. Os pacientes que aplicaram essa estratégia aumentaram o consumo calórico de carboidratos e diminuíram o consumo de lipídeos.