Practices, perceptions and expectations for carbohydrate counting in patients with type 1 diabetes - Results from an online survey

Aims: Characterize adult patients with diabetes on intensive insulin therapy in terms of: (a) practices and perceived difficulties relative to carbohydrate counting (CC) and diabetes treatment, and (b) their perceptions and expectations relative to CC.

Methods: Participants completed a 30-question web-based questionnaire.

Results: Participants with type 1 diabetes (T1D) and using CC as part of their treatment plan (n=180) were included in this analysis. Participants were predominantly women (64%), aged 42±13years old and had diabetes for 22±13years. A large proportion of participants reported being confident in applying CC (78%) and considered precise CC as being important for glycemic control (91%), while only 17% reported finding CC difficult. Despite the low perceived difficulty associated with CC, many specific difficulties were encountered by patients such as the perception that glycemia fluctuates even with appropriate CC and that CC complicates the management of diabetes. A larger proportion of participants with a lower level of education (<university degree) and current or history of depression reported not feeling confident in applying CC. Most respondents believed that new technologies could facilitate CC (57%) and would be interested in such technology (62%).

Conclusions: Although a majority of participant reported being confident in applying CC, many difficulties and constraints associated with CC have been identified. These results highlight that patients with a lower level of education and with a history or current depression could benefit from specific CC education strategies. Future studies should examine the efficacy of technology tools to facilitate CC.