Carbohydrate counting is an important step in helping your diabetes control.

It requires time and motivation to learn but benefits include:

• Being more flexible with eating and drinking
• Being able to choose the times you eat and drink
• Understanding the knowledge of your diabetes control

You can self-refer to the Forth Valley Diabetes Dietitians to book into our carbohydrate counting group sessions. This involves two sessions over two weeks where we teach you first how to carbohydrate count and then discuss individual insulin to carbohydrate ratio’s unique to you. This will provide you with the tools to adjust your fast acting insulin based on your carbohydrate portion.

If you have carbohydrate counted before but you want to refresh your skills there is a refresher video on the website and workbook to use. You can then get in touch if you feel you need input to adjust your ratios.

You can get in touch with the contact details below to self refer for carbohydrate groups or one to one appointments.

Phone: 03124 566626
Email: fv.fvdiabetesdietitians@nhs.scot

There is no specific diet for Type 1 Diabetes. As per the recommendations for the general population we encourage you to follow a healthy balanced diet & lifestyle.

Making healthy food choices can help reduce the risks of diabetic complications and illnesses such as heart disease and stroke in the future. A Diabetes Dietitian can help advice on a healthy balanced diet.

For more information and healthy meal ideas, see the Diabetes UK website.

It can be tricky working out what to eat and how much when managing blood glucose with insulin. All carbohydrates in the diet will affect your blood glucose levels. Knowing how to adjust your fast acting insulin for carbohydrates can help keep your blood glucose levels stable. The best way to do this is by carbohydrate counting.

We can teach you how to Carbohydrate Count which will enable you to safely adjust fast-acting insulin and allow flexibility around meals and snacks. You can read more about carbohydrate counting here:

• Diabetes UK Carbohydrate counting
• Diabetes UK healthy balanced diet

If you have carbohydrate counted in the past and need a refresher we have a video on the virtual education page and you can download a workbook to go alongside it. You can then get in touch if you feel you need input to adjust your ratios.

If you have not carbohydrate counted before we have group session to learn to carbohydrate count and use an insulin to carbohydrate ratio. Please see the carbohydrate counting section for more information on the groups and how to self refer.

We do not recommend following a low carbohydrate diet for Type 1 diabetes.

Phone: 03124 566626
Email: fv.fvdiabetesdietitians@nhs.scot

Maintaining a healthy weight and lifestyle is important to reduce the risk of health conditions like heart disease, stroke, some cancers and osteoporosis. Healthy eating is important for both Type 1 and Type 2 diabetes.

For more information on healthy eating please see the following British Dietetic Food Fact sheet for information and Diabetes UK website.

If you are looking to loose weight please see the Forth Valley Choose to Lose webpage which has a step by step guide to help you with your weight loss journey as well as a self monitoring workbook to help keep you motivated.

In the UK, the guidelines for vitamin D supplementation are the same for anyone living with type 1 diabetes as that for the general population.

Vitamin D is made by the body from sunlight. We get some vitamin D from food but it is unlikely to provide enough to meet requirements. In northern countries such as the UK, getting enough vitamin D from sunlight can also be difficult. The sun’s rays are only strong enough to make vitamin D between April and September. However during these times when the sun is strong enough to make vitamin D, it is also important to protect the skin from harmful UV rays.

Finding a balance can be difficult. Therefore it is recommended that all adults over the age of 1 year should take a 10 microgram (μg) daily vitamin D supplement year round, and especially during autumn and winter.

Vitamin D rich foods:

• oily fish such as salmon, sardines, pilchards, trout, herring, kippers and eel
• cod liver oil (not to be taken in pregnancy)
• egg yolk, meat, offal and milk contain small amounts but this varies during the seasons
• fortified foods – margarine, some breakfast cereals, fortified plant based milk, infant formula milk

For more information see the British Dietetic Association page on Vitamin D.

You can read more information on the NHS website.

You can still drink alcohol if you take insulin. Alcoholic drinks may make your blood glucose rise initially but there is a risk of hypoglycaemia when drinking.

If you take insulin, do not take any extra insulin for alcoholic drinks or mixers and have a carbohydrate snack before bed. You may find your blood glucose is low the following day therefore check your blood glucose regularly.

It is important that you know how to manage your blood glucose if consuming alcohol.

For more information see the Diabetes UK website on alcohol and diabetes.

You will likely have noticed a difference in your blood glucose levels depending on the type of carbohydrate and portion size of the meal or snack you have consumed. This can be due to the Glycaemic Index (GI) of the food.

The Glycaemic Index (GI) of a food tells us whether it raises blood glucose levels quickly, moderately or slowly. Different carbohydrates are digested and absorbed at different rates. GI is a ranking of how quickly each carbohydrate-based food or drink causes blood glucose levels to rise after eating them.

Slowly absorbed carbohydrates have a low GI rating, and include most fruits and vegetables, unsweetened milk, nuts, pulses, some wholegrain cereals and bread. Choosing more low GI foods can help keep blood glucose levels steady after eating.

Factors that affect GI and blood glucose levels:

• Fibre – wholegrain and high-fibre foods slow down the digestion of carbohydrate. This is not the same as ‘wholemeal’ as it has been ground instead of left whole.
• Fat – lowers GI, for example chocolate or crisps. Low GI doesn’t always mean healthy!
• Cooking methods – frying, boiling and baking e.g. Pasta cooked for longer has a higher GI
• Protein – lowers GI so milk and dairy products have a slower impact on blood glucose levels

Knowing how quickly a food will raise blood glucose levels can be helpful for thinking about the timing of your insulin to prevent large spikes in blood glucose levels.

You can read more detail about Glycaemic Index here.

Would you like to be more physically active but are anxious about how this will affect your blood glucose(BG) levels? Come along to one of our sessions at the University of Stirling.

We will discuss the effects of different types of exercise on BG levels and after lunch you will do a spin class with us and then discuss what happened.

This class is suitable for all abilities, and for people both using insulin pen injections and insulin pump therapy.

The aim of Active Forth is to give the individual an opportunity to become more active and gain the benefits of a healthier lifestyle.

They will take part in a structured physical activity programme supported by our physical activity consultants in 1 of our 4 gyms. They will have the option to take part in supported active forth classes, gym sessions and swimming.

This programme runs for 6 months. The PA consultant will create a plan for ongoing exercise after this point where the individual will be able to continue their exercise routine.

Active Forth is for any age group from 11+. Access to this service is payable via monthly membership or per visit – this will be discussed with patient at first appointment. If cost is an issue, please consider our award-winning Step Forth free walking programme.