INS and diabetes mellitus: While some studies showed improvement in HbA1c values (standard mean difference [95%CI]: -0.51 [-0.83, -019] %) when insulin dosing was combined with precise CC and was compared to standard diabetes education (16), evidence for CC superiority is less clear when compared to other dietary approaches of matching insulin to food intake (-0.31 [-0.99, 1.61]%) such as glycemic index or fixed carbohydrate amounts (18).