Diabetes patients' ability to estimate dietary carbohydrate content for use in a decision support system

The aim of the study was to assess Type 1 (insulin-dependent) diabetic patients' ability to give valid information of the dietary carbohydrate (CHO) intake and to use the log function of a blood glucose meter for easy transfer of data to a decision support system. 18 Type 1 diabetic patients were enrolled from the Diabetes Outpatient Clinic at the Department of Endocrinology, Aalborg Hospital, Denmark. The patients were divided in subgroups of 4 or 5 patients and was instructed by the dietitian how to estimate the CHO intake and by the doctor in the use of the Accutrend DM blood glucose meter. During a 3 days data collecting period the patients were asked to keep a written diary containing a description of the meals, the estimated CHO intake, the insulin-dosage and the time of the meals and insulin injections, and to make 8-point blood glucose profiles daily. They were furthermore asked to use the log function of the Accutrend DM blood glucose meter. At the second visit the data were discussed individually with the patients and if there where more than three data points missing using the log function the patients were asked to repeat the data collection. A deviation of 10 grams or more, between the patient's and the dietician's estimate, was seen in 7.3% of the meals following the first instruction, in 1.0% of the meals following the second instruction, and in 2.4% of the meals following the third and last instruction. In conclusion, this study showed that Danish Type 1 diabetic patients were able to estimate the dietary carbohydrate content with a high degree of correctness, and to use the log function of the blood glucose meter, after a maximum of 3 hours of training.