Accuracy of carbohydrate counting in patients with type 1 diabetes using insulin pump therapy

Aim To investigate the ability of patients with Type 1 Diabetes to visually estimate the carbohydrate content in meals/snacks, and to evaluate difficulties and concerns regarding CC. Methods Nineteen patients with Type 1 diabetes on insulin pump therapy who presented consecutively at an outpatient clinic were asked to visually estimate the carbohydrate content in 15 meals and snacks and complete a questionnaire around their experience of CC. Results Over half the participants felt confident/very confident about incorporating CC into daily life, 84.2% (n=16) reported not finding CC difficult and 68.4% (n=13) found apps a helpful aid. The mean score for the carbohydrate content assessment was 4.7 (SD =2, min = 1 and max = 8). Sixteen (84.3%) found fat/calorie dense meals difficult to account for. In addition, 42.1% (n=8) avoided certain foods as they could not gauge the carbohydrate content. Five (26.3%) felt it complicated the management of their diabetes while 42.1% (n=8) felt their blood sugars fluctuated a lot even if CC. Conclusion Despite appropriate and comprehensive education in CC these skills decline with time and repeated interval education is important. We recommend the introduction of regular refresher courses within the healthcare setting to improve diabetes management.