Carbohydrate counting of food.

QUESTIONS UNDER STUDY

Carbohydrate counting is a principal strategy in nutritional management of type 1 diabetes. The Nutri-Learn buffet (NLB) is a new computer-based tool for patient instruction in carbohydrate counting. It is based on food dummies made of plastic equipped with a microchip containing relevant food content data. The tool enables the dietician to assess the patient's food counting abilities and the patient to learn in a hands-on interactive manner to estimate food contents such as carbohydrate content.

METHODS

Multicentre randomised controlled trial in 134 patients with type 1 diabetes comparing the use of the Nutri-Learn buffet in determining and improving ability to estimate the carbohydrate content of food with the use of conventional counselling tools (i.e. pictures and tables).

RESULTS

The NLB group showed significantly better carbohydrate estimation values than the control group. In particular, there was a significant improvement in estimation of starches, fruits and sweets. The NLB was preferred by patients and dieticians in that rating of carbohydrate was closer to reality than the use of conventional tools, and since the tool has a play element, is interactive and adjustable, and can be used with only minimal knowledge of a specific language.

CONCLUSIONS

Adjustment of preprandial insulin doses to the amounts of dietary carbohydrates ingested during the subsequent meal resulted in improved metabolic control in previous studies. The present study demonstrated that the new tool (Nutri-Learn buffet) improved teaching and learning of carbohydrate counting. In addition, it allowed an objective assessment of the carbohydrate counting skills of patients by the dietician. The findings therefore suggest that the tool is helpful in nutritional counselling of patients with diabetes mellitus.