Carbohydrate and preprandial insulin determination in diabetes: a review.

Aim: This review evaluates the various methods of determining preprandial insulin doses in relation to carbohydrate intake. Methods: A search was conducted in the Medline and ProQuest databases. Intervention or discussion papers involving insulin requirements and carbohydrate estimation, or the glycaemic response to food were reviewed. Results: The amount of carbohydrate and the glycaemic index both significantly affect glycaemic response and insulin requirements. Most carbohydrate estimation methods improve glycaemic control and some reduce hypoglycaemia. Carbohydrate 'counting' involves more complex processes, has a higher patient burden than qualitative methods and may lead to negative food choices. Conclusions: No one method of carbohydrate estimation is better at predicting preprandial insulin requirements. Qualitative methods may be preferred due to the ease of execution and adherence issues. [ABSTRACT FROM AUTHOR]