Counting those Carbohydrates; Improvements seen during the FlexIT program — ASN Events
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Counting those Carbohydrates; Improvements seen during the FlexIT program (#401)

Sonia Middleton 1 , Kate Logie-Smith 1 , Rebecca Stiegler 1 , Rebecca Gallo
  1. Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia

Background: The Flexible Insulin Adjustment Program (FlexIT) conducted at Baker IDI provides people with Type 1 diabetes greater flexibility to match daily insulin to carbohydrate intake and lifestyle factors.

Aim: To evaluate carbohydrate counting ability for patients attending the FlexIT pre, post and 12 months after the program.

Method: The FlexIT program involved two, six hour face to face sessions with a dietitian and diabetes nurse educator.  A questionnaire was administered pre, post and 12 months after the program. This included an adapted PedCarbQuiz (PCQ) to assess carbohydrate counting ability. Some validated general diabetes knowledge questions were also incorporated. Participants were taught to count carbohydrates by the use of labels, weighing and measuring and using Apps and internet databases. Strategies were also provided for eating out and home cooked meals. The Baker IDI ‘Counting Carbs in Grams’ booklet were provided to all participants.

Results: 58 participants were enrolled in the program.  (Average age 42, 56% female and mean duration of diabetes was 16 years). The average HbA1C at baseline was 7.9% (n=45). Participants with a lower HbA1c were more frequently self-blood glucose monitoring (p=0.11) at the commencement of the program.

The frequency of participants calculating/weighing/measuring/reading labels, to work out the carbohydrate content of meals significantly improved from pre to post program (p=0.001). The adapted PCQ score improved from 16.8 to 22.25 out of a possible score of 27 however this was not significant (p= 0.082).   Preliminary findings at 12 months suggest that carbohydrate counting ability may be sustained with the mean average score of 24 (n=12).

Those ketone testing significantly improved from 45% to 74% post program (p=0.021) along with knowledge of signs of ketoacidosis (p=0.0001). Treatment of hypoglycaemia also significantly improved (p=0.010).

Conclusion: Participants in the FlexIT program showed improvements in carbohydrate counting pre and post program however more 12 month questionnaires are required to determine if this improvement is sustained for the long-term. Significant improvements were also seen in ketone testing and hypoglycaemia management.