Dietary practices of persons with diabetes during insulin pump therapy

Eating behaviors and diet composition were investigated in 15 individuals with insulin-dependent diabetes treated by continuous subcutaneous insulin infusion (CSII). Glycemic control was significantly improved and was near normal during pump treatment. Patients were interviewed with the use of a structured questionnaire composed of multiple question formats to document dietary practices and to identify changes from conventional therapy. Mealtimes were varied considerably on both conventional and pump therapy (as much as 110 +/- 19 and 126 +/- 20 minutes, respectively), but mealtime delays were reported to be manageable while the patients were using the pump. The practices of eating larger meals or additional snacks compensated for by extra insulin significantly increased during CSII therapy. Partly as a consequence of such practices, patients experienced a significant weight gain of 7.2 +/- 2 lb during pump treatment (p less than .005). Clearly, prospective studies are needed to determine the acceptable degree of dietary flexibility and the optimal management of diet during insulin pump therapy.