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CarbAware for Type 1 diabetes

Short 3-hour carbohydrate awareness courses for people with Type 1 diabetes

This course is to improve glucose control. It is a short structured 3-h group teaching delivered by a specially trained dietician. The curriculum covers different aspects of diabetes: food recommendations, self-monitoring of BG techniques, insulin profiles, and appropriate management of hypo- and hyperglycaemia in general and in relation to stress, infections, menstrual periods, alcohol intake, and exercise. Emphasis is put on empowering patients to make rational day-to-day insulin dosage adjustment. People with T1DM are taught principles of a healthful diabetes diet, how to estimate the carbohydrate content of foods, and how to calculate insulin-CHO-ratios and insulin sensitivity factors using recognised formulas Patients are shown how to use the bolus calculator function on a function enabled blood glucose testing meeting (Aviva Expert, Roche) and provided with this meter. Carbohydrate counting education is by both theory and practical exercises. Patients are asked to do a minimum of 4 blood glucose tests per day to ideally do a blood glucose test before every meal.

Average HbA1c reduction is 11mmol/mol. Self assessed confidence in all aspects of carbohydrate assessment increased following the course, as did intention to increase monitoring. There is a very high level of satisfaction with the content, method and timing of the course. There was an initial high non-attendance rate >50%, but this has now fallen to <20%.

The Carb Aware referral form is on DXS where it can be completed and sent to the HUB.