Abstract
Aim Correct estimation of meal carbohydrate content is a prerequisite for
successful intensified insulin therapy in patients with diabetes. In this
survey, the counting error in adult patients with type 1 diabetes was
investigated.
Methods Seventy-four patients with type 1 diabetes estimated the
carbohydrate content of 24 standardized test meals. The test meals were
categorized into 1 of 3 groups with different carbohydrate content: low, medium,
and high. Estimation results were compared with the meals’ actual
carbohydrate content as determined by calculation based on weighing. A subgroup
of the participants estimated the test meals for a second (n=35) and a
third time (n=22) with a mean period of 11 months between the
estimations.
Results During the first estimation, the carbohydrate content was
underestimated by −28% (−50, 0) of the actual
carbohydrate content. Particularly meals with high mean carbohydrate content
were underestimated by −34% (−56, −13). Median
counting error improved significantly when estimations were performed for a
second time (p<0.001).
Conclusions Participants generally underestimated the carbohydrate content
of the test meals, especially in meals with higher carbohydrate content.
Repetition of estimation resulted in significant improvements in estimation
accuracy and is important for the maintenance of correct carbohydrate
estimations. The ability to estimate the carbohydrate content of a meal should
be checked and trained regularly in patients with diabetes.
Key words
diabetes - carbohydrate counting - estimation accuracy
