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Abstract

Carbohydrate counting has provided flexibility in the meal plans of people with type 1 diabetes, although for many, it can represent a treatment burden.

Advances in insulin infusion technology have sought to relieve users of this burden. While the most advanced automated systems allow for less precise counting and make corrections for certain inaccuracies, the user still needs to estimate the amount of carbohydrates—as well as proteins and fats—in their meals.

If there is a significant discrepancy between the carbohydrates reported to the system and those actually consumed, major postprandial glucose excursions will occur and the automated system's algorithm cannot fully correct.

Furthermore, users must continue to account for the protein and fat content of their meals. Based on past experience with similar meals, they need to decide how to input this information into the infusion device to tailor insulin delivery to their needs, taking into account the specific impact these types of meals have on early and late postprandial glucose responses.

Even with the most advanced systems that offer a meal announcement feature, it remains necessary to estimate carbohydrate intake to decide how to log the meal and whether or not to use the "auto-meal" option. If the intake differs from the usual amount, manual carbohydrate entry is required to improve the automated system's adjustments.

While future systems may require less precision in macronutrient counting, nutritional education remains a key factor in optimizing glycemic control, empowering patients to make healthy food choices and emphasizing nutritional quality.