Kantonsspital St.Gallen

Carbohydrate counting of food

Karin Hegar, Stefanie Heiber, Michael Brändle, Emanuel Christ & Ulrich Keller


Carbohydrate counting is a principal strategy in nutritional management of type 1 diabetes. The Nutri-Learn buffet (NLB) is a new computer-based tool for patient instruction in carbohydrate counting. It is based on food dummies made of plastic equipped with a microchip containing relevant food content data. The tool enables the dietician to assess the patient's food counting abilities and the patient to learn in a hands-on interactive manner to estimate food contents such as carbohydrate content.

Multicentre randomised controlled trial in 134 patients with type 1 diabetes comparing the use of the Nutri-Learn buffet in determining and improving ability to estimate the carbohydrate content of food with the use of conventional counselling tools (i.e. pictures and tables).

The NLB group showed significantly better carbohydrate estimation values than the control group. In particular, there was a significant improvement in estimation of starches, fruits and sweets. The NLB was preferred by patients and dieticians in that rating of carbohydrate was closer to reality than the use of conventional tools, and since the tool has a play element, is interactive and adjustable, and can be used with only minimal knowledge of a specific language.

Adjustment of preprandial insulin doses to the amounts of dietary carbohydrates ingested during the subsequent meal resulted in improved metabolic control in previous studies. The present study demonstrated that the new tool (Nutri-Learn buffet) improved teaching and learning of carbohydrate counting. In addition, it allowed an objective assessment of the carbohydrate counting skills of patients by the dietician. The findings therefore suggest that the tool is helpful in nutritional counselling of patients with diabetes mellitus.
citation Hegar K, Heiber S, Brändle M, Christ E, Keller U. Carbohydrate counting of food. Swiss Med Wkly 2011; 141:w13224.
type journal paper/review (English)
date of publishing 07-07-2011
journal title Swiss Med Wkly (141)
ISSN electronic 1424-3997
pages w13224
PubMed 21735362
DOI 10.4414/smw.2011.13224