P.L.KOH1, P.SHARDA2, E.YEOH3, TAVINTHARAN.S3
Woodlands Health1, Sengkang General Hospital2, Khoo Teck Puat Hospital3
Flexible Insulin therapy based on basal and prandial insulin therapy is recommended for people with Type 1 diabetes (T1D). Bolus insulin is given with each meal. Patients can achieve target post prandial blood glucose levels with the right amount of bolus insulin given to the amount of carbohydrates he or she plans to consume. We aimed to evaluate the perception of adults with T1D on carbohydrate counting (CC) for insulin titration and the challenges faced in our diabetes centre.
We recruited patients with Type 1 Diabetes or Latent Autoimmune Diabetes of Adult (LADA) from our clinic. We surveyed on their prior experience in learning CC. We traced their most recent HbA1c results and analyzed the association between their practice of CC and HbA1c level.
The majority (N = 62, 83%) of patients had received prior education on CC for prandial insulin titration. 45 patients (60%) counted carbohydrate for insulin titration, the rest did not count. Majority (35%) eye ball food portion and made a rough estimation, followed by 12% of patient used the food composition table given by dietitian and 5% used mobile application to look for carbohydrate content.We found that patients who received prior education on CC tend to count carbohydrate for insulin titration (41 out of 45, p value =0.018).
In conclusion, CC for prandial insulin titration remains a challenge to many patients with T1D. Prior education helped to improve adherence to CC.