Following the last two diabetes columns, which focused on blood glucose targets and total daily doses, we continue with the self-management tips (for more details visit diabetes matters on facebook.com) This week we will discuss insulin to carbohydrate CHO ratio.

Injecting correct amount of rapid acting insulin for the carbohydrate portion is the best way to control blood glucose levels and provides flexibility and freedom with food. There is a myth about people with type 1 diabetes not being able to eat certain things like bananas or tomatoes etc.

People with type 1 diabetes who have no problem with body weight could eat what they wish but have to inject insulin in order to control their glucose levels before and after food. People with excess weight should try to loose weight therefore they may have to be aware not only of the carbohydrate portions but also about the calories in their diet (for more info visit previous DT1 column or diabetes matters on facebook.com)

Knowing your insulin to CHO ratio is very important.

Starting with standard ratio of 1unit of rapid acting insulin to every 12g to 15g of CHO is good staring point.

Some people may require higher or lower ratios. Ratios may also vary depending the time of the day, it could be different for breakfast, lunch and dinner. There are many resources available to help with carbohydrates counting including books, measuring scales with food choices or info on the food packaging.

Many people, including me, eat the same thing for breakfast or lunch, once checked the CHO portion it could be repeated. The most difficult time for many people is dinnertime especially when homemade. I would recommend talking to dietitian to help with that. I hope this was enough to encourage people to start thinking about carbohydrate counting; there are many CHO counting courses available on-line or local group education sessions. For more details please contact your local diabetes team.

AGNIESZKA GRAJA

DIABETES SPECIALIST NURSE AND DIABETES UK CLINICAL CHAMPION