Diet in patients using insulin pumps or 'pen' injectors

Patients with insulin-dependent diabetes managed with continuous subcutaneous insulin infusion or a combination of pre-prandial injections of short-acting insulin and once or twice daily long-acting insulin have a number of dietary advantages. These include;

• The ability to adapt insulin dose allows this group of patients to vary the carbohydrate content of individual meals on a meal-to-meal basis.
• The number of meals eaten each day can be reduced as mid-morning and mid-afternoon snacks are not required.
• Meal need no longer be eaten at pre-determined times of day.

This additional dietary freedom is however open to abuse and patients can all to easily find themselves;

• Increasing their energy intake by eating meals with high carbohydrate content on a regular basis and ironically by over-snacking resulting in obesity and/or
• Missing meals on a regular basis, for example breakfast.

NICE state regarding type 1 diabetes (1)

Dietary management

Carbohydrate counting

• offer carbohydrate-counting training to adults with type 1 diabetes as part of structured education programmes for self-management
• consider carbohydrate-counting courses for adults with type 1 diabetes who are waiting for a more detailed structured education programme or are unable to take part in a stand-alone structured education programme

Glycaemic index diets

• do not advise adults with type 1 diabetes to follow a low glycaemic index diet for blood glucose control

Reference:

• NICE (August 2015). Type 1 diabetes in adults: diagnosis and management