Finding Help with Carb Counting

One of the many ways people manage their type 1 diabetes is Carbohydrate Counting or Carb Counting. Carb counting has been a successful way to help manage type 1 diabetes while giving us a more flexible lifestyle since the 1990's. But it has only really taken off in Ireland since the noughts.

Carb counting is based on the idea that if the carbs in our food make our blood glucose levels rise consistently, then it makes sense to try and measure them and come up with insulin to carb ratios. It can be a lot of work in the first two or three weeks but after that it most of the work involved does not have to be repeated. 

So, if you are a person with type 1 diabetes and are interested in learning more about carb counting, where do you start?

In Ireland, there are two structured education courses for adults, DAFNE(Dose Adjustment For Normal Eating) and BERGER. 

The DAFNE course originated in Germany in the 1980's as the Düsseldorf Approach. It was designed by the diabetes team at the Diabetes Centre in Düsseldorf, led by Michael Berger. People learned to match their insulin dose to their food on a meal-by-meal basis. The aim is that they can keep healthy blood glucose control without a higher risk of severe hypoglycaemia. 

In 1998, a team from the UK adapted the Düsseldorf Approach creating the Dose Adjustment For Normal Eating (DAFNE). 

There are 6 diabetes centres in Ireland running DAFNE, click here for the list, and the diabetes centre in University Hospital Cork runs a variation of DAFNE, which is named after the original creator, BERGER.

The parents of children with diabetes have the CHOICE programme and that is run in the 5 paediatric diabetes centres that offer insulin pump therapy to their patients.

The six up and running paediatric diabetes centres offering the CHOICE programme are;

• Adelaide & Meath Hospitals, incorporating the National Children‟s Hospital (AMNCH), (Dublin)
• Children‟s University Hospital, Temple Street, (Dublin)
• Cork University Hospital, (Cork)
• University Hospital Limerick /University Hospital Galway, (Limerick / Galway)
• Our Lady‟s Hospital for Sick Children, Crumlin, (Dublin) 

• And soon to be up and running Sligo General

If you don't attend any of these centres, you might have access to a dietitian who would work one on one to teach you carb counting.

If this option isn't available at your diabetes clinic you should be able to find a dietitian who runs a private practise who will instruct you in carb counting, such as the services provided by Diabetes Insight in Cork. 

However, when you call to make the appointment be clear about the fact that you want to learn how to carb count and how to work out insulin to carb ratios.

If you are interested in learning more about carb counting, the wonderful people at InPut Diabetes in the UK have some excellent resources.