Patients on intensive insulin therapy regimens are taught how to adjust their insulin doses to the food they eat. However, some diabetes teams in the United Kingdom prefer to encourage the principles of healthy eating instead, partly due to the perception that people who are comfortable adjusting their insulin doses will be tempted to eat more junk food.
A team in southern England conducted research to see whether this perception was true. They surveyed 21 patients undergoing intensive insulin therapy before and eight months after an educational intervention on adjusting dose to food. They found that, while there was some experimentation in the early days of education, most patients ate similar amounts of high-fat carbohydrates after the education. Between 5% and 26% of the patients increased their consumption of junk foods as follows:
- More pastry - 5%
- More puddings, cakes and cookies - 16%
- More chips and nuts - 19%
- More sugar and sugary food - 26%
Patients had better blood glucose levels day to day, regardless of the type of carbohydrate they consumed. And more than 80% achieved reductions in their HbA1c. All felt confident in adjusting their insulin dose, but 28% felt that they needed more practice to adjust for meals from restaurants that lack nutritional labeling.
Lifestyle - Diet
Source: Kentish JL, Murphy J, Cavan DA, et al. Do patients eat more junk food when taught how to adjust their insulin? Presentation at ADA meeting, June 23, 2001. (Abs.)