Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes

Brazeau, Anne‐Sophie; Mircescu, Hortensia; Desjardins, Katherine; Leroux, Catherine; Strychar, Irène; Ekoé, Jean‐Marie; Rabasa‐Lhoret, Rémi

doi:10.1016/j.diabres.2012.10.024

Cited by 205 publications

(157 citation statements)

References 18 publications

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“…Insulin dose requirements may have been partially affected by inaccurate carbohydrate counting, as has been reported elsewhere; 25 another possibility is that in people with a limited carbohydrate intake, gluconeogenesis becomes such an important source of glucose that it becomes necessary to also calculate the protein content of a meal and use an insulin:carbohydrate and protein ratio. 26 Mealtime insulin resistance in people with Type 1 diabetes on low carbohydrate diets has not been reported elsewhere, and this finding requires further exploration to see whether it has relevance for other people with Type 1 diabetes who may wish to try low-carbohydrate eating.…”

Section: Discussionmentioning

confidence: 89%

From 'pleasure to chemistry': the experience of carbohydrate counting with and without carbohydrate restriction for people with Type 1 diabetes

Cresswell¹,

Krebs²,

Gilmour³

et al. 2015

J Prim Health Care

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INTRODUCTION:Matching carbohydrate intake with insulin dosage is recommended management for people with Type 1 diabetes. However, international interest in restricted carbohydrate diets is growing. General practitioners and practice nurses need to know how to advise people with Type 1 diabetes regarding low-carbohydrate diets. This study aimed to explore the carbohydrate counting experiences of people with Type 1 diabetes in a trial with and without a diet restricted to 75 g of carbohydrate per day.

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Section: Discussionmentioning

confidence: 89%

From 'pleasure to chemistry': the experience of carbohydrate counting with and without carbohydrate restriction for people with Type 1 diabetes

Cresswell¹,

Krebs²,

Gilmour³

et al. 2015

J Prim Health Care

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show abstract

“…This addresses the variable eating habits of children and adolescents. Carbohydrate counting allows flexible food planning, and the meal planning approach is important for the physical and psychological development of children and adolescents with diabetes [8][9][10] .…”

Section: Palavras-chave: Carboidratos Diabetes Mellitus Tipo 1 Educmentioning

confidence: 99%

Training adolescents with type 1 diabetes to carbohydrate counting without parents' help

et al. 2016

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Objective: To develop and evaluate the effectiveness of a nutrition education program to enable adolescents with type 1 diabetes to count carbohydrates without the parents' help. Methods: Nineteen adolescents with type 1 diabetes from a diabetes center participated in four fortnightly meetings of one hour, with lectures and discussions about healthy nutrition, importance of nutrients for blood glucose, portion sizes, food replacements, and carbohydrate counting therapy. All meetings ended with exercises to check the learning. Adolescents were followed for one year after the intervention. Results: All participants were 100% successful in all the steps of the program and started carbohydrate counting in the main meals. Nutritional status and total daily insulin doses before and after the study did not differ. After 12 months, 68% of the adolescents counted carbohydrates at all times, 16% did so in extra snacks, and 16% were suspended from the new therapy. Eighty percent of the parents were satisfied with the program, believing teenagers were trained in the new therapy. Conclusion: A short nutrition education program successfully trained adolescents to count carbohydrates without the parents' help.

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“…But even several hours after the meal, slowly absorbed insulin can cause hypoglycemia. With that in mind, it is hardly surprising that many people are struggling to estimate the bolus size (Burdick et al, 2004;Brazeau et al, 2013). Furthermore, occasionally omitted insulin boluses compromise the outcome of the therapy.…”

Section: Introductionmentioning

confidence: 99%

Impact of sensing and infusion site dependent dynamics on insulin bolus based meal compensation

2017

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Meals are most challenging in the regulation of blood glucose levels (BGL) in diabetes mellitus type 1, whether it is automated, semi-automated or manually controlled. The common subcutaneous (SC) route for glucose sensing and insulin administration suffers from large latencies. This paper investigates the impact of glucose sensing and insulin absorption dynamics on the achievable glucose regulation when insulin boluses are triggered by a meal detection system. In silico patients from the academic version of the UVa/Padova simulator are studied. The sub-models of glucose sensing and insulin absorption are adjusted to allow simulations with different time delays and time constants. Meals are detected with published methods based on threshold-checking of continuous glucose monitoring data. Slow glucose sensing dynamics delay the meal detection. Delayed meal detection can be compensated to some extent by exact knowledge about the insulin absorption. The combination of slow glucose sensing and slow insulin administration reduces the effect of insulin boluses on the postprandial BGL. The classical SC approach is, therefore, at high risk of large BGL excursions despite meal detection.

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Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes

Cited by 205 publications

References 18 publications

From 'pleasure to chemistry': the experience of carbohydrate counting with and without carbohydrate restriction for people with Type 1 diabetes

From 'pleasure to chemistry': the experience of carbohydrate counting with and without carbohydrate restriction for people with Type 1 diabetes

Training adolescents with type 1 diabetes to carbohydrate counting without parents' help

Impact of sensing and infusion site dependent dynamics on insulin bolus based meal compensation

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