Endocrine Abstracts

Background: By using new treatment modalities in DM1 patients (glucose sensors, insulin pumps) we quite often do not reach optimal results.

Objective: As a part of the project developing software for smartphones (a self-learning diabetes management advisory tool) we provided in insulin pump users detail diet and RT-CGM records analysis. As the main cause of postprandial hyperglycaemia in our DM1 patients we identified dietary mistakes. Moreover diet of our patients was often unhealthy. We decided to obtain real insight into DM1 patient diet in a larger cohort because dietary mistakes may interfere with new treatment approaches.

Methods: In this study 30 DM1 patients (15/15 F/M; 20/30 already suffering from chronic diabetic complications) were involved (median, range): age 41 years (23–55), DM1 duration 20 years (4–25), 15 used CSII, 15 MDI, insulin dose 0.6 IU/kg (0.4–1), BMI 25.3 (21.2–34.8), HbA1c 66 mmol/mol (48–89) IFCC. They were instructed to document one week all food and drinks by smartphone camera and to record a log book including weight of all food. Their diet was analysed by professional nutritional software (NutriPro EXPERT). Notice - all patients underwent standard intensified diabetic education within last two years.

Results: (median, range) in % of recommended daily value: Energy intake:115% (94–160%), total carbohydrates 103% (66–113%), mono- and oligosaccharides 130% (93–166%), proteins 98% (70–130%), total fat 140% (120–201%), saturates 135% (115–186%), cholesterol 98% (94–110%), fiber 74% (66–103%), Na 117% (104–150%), Fe 72% (60–93%), Ca 83% (66–93%), vit. C 100% (80–121%), vit.D 54% (35–83%). Pump users made mistakes more often (P=0.01).

Patients did not consider their diet as unhealthy. Generally they considered only total carbohydrate content as important.

Conclusion: Prior analysis of any new DM1 treatment modality patient’s compliance and knowledge (including diet) must be checked and re-educated if necessary.

Supported by the Czech Ministry of Health Project No.15-25710A(P08 panel).