Skills Lacking in Estimating Carbohydrate Content: A Need for Continual Education of Adults with Type 1 Diabetes

Aim: To examine whether adults with type 1 diabetes (T1D) educated in counting carbohydrates can identify and correctly estimate the carbohydrate content, and to examine whether these skills are associated with lower glycated haemoglobin A1c (HbA1c).

Methods: Ninety-six patients with T1D on insulin pump therapy participated. We assessed skills in categorising 32 food items as either high- or low-carbohydrate and estimating carbohydrate portion sizes in 20 typical Danish high-carbohydrate food items. We calculated error estimates for carbohydrate portion sizes and examined patient characteristics with a likely impact on estimation accuracy.

Results: An average of 88% correct answers ranging from 21 to 100% were found for the high- or low-carbohydrate food items. The participants’ estimations differed significantly from the correct carbohydrate content in 17 of 20 typical Danish high-carbohydrate food items. No significant associations were found between HbA1c and the ability to estimate carbohydrates correctly.

Conclusion: Although adults with T1D previously educated in basic carbohydrate counting can identify high-carbohydrate food items, they lack skills in correctly estimating carbohydrate portion sizes. Our results underline the need for continual education to strengthen and maintain skills in carbohydrate estimation.