Researchers in Sweden asked 191 adults with type 1 diabetes about their eating habits and challenges managing their blood sugar through diet. They found that most people eat less fiber and more saturated fat than recommended. About half struggle with counting carbohydrates (a key part of managing blood sugar), and many avoid certain foods because they worry about blood sugar spikes. The study shows that many people want more help from dietitians to improve their eating habits and blood sugar control.

The Quick Take

  • What they studied: How people with type 1 diabetes eat, what challenges they face with food and blood sugar management, and whether they want more help from nutrition experts
  • Who participated: 191 Swedish adults with type 1 diabetes, average age 48 years old, about half were women. They filled out an online survey about their eating habits and food choices
  • Key finding: More than half of participants found it hard to count carbohydrates (the main way people with type 1 diabetes manage blood sugar through food), and most weren’t eating enough fiber or eating too much saturated fat compared to health guidelines
  • What it means for you: If you have type 1 diabetes, you’re not alone if carbohydrate counting feels difficult. Many people struggle with this, and about one-third want more professional help from dietitians. Better nutrition support could help improve blood sugar control and overall health.

The Research Details

Swedish researchers created an online survey and asked people with type 1 diabetes to answer questions about what they eat and the challenges they face. They used a validated food questionnaire (a tool that experts have tested and proven works well) to measure what people actually eat. They also asked about how people count carbohydrates, what foods they avoid, and whether they feel they get enough help from their doctors and nurses.

The researchers collected information from three diabetes clinics in Sweden and got responses from 191 people. They looked at the answers to see what patterns appeared—for example, how many people struggled with carbohydrate counting and whether certain groups had different eating habits. They also compared what people were eating to official health guidelines to see if they were getting the right amounts of different nutrients.

This type of study is important because it shows what’s actually happening in real life with real people, rather than just testing something in a lab. By asking people directly about their challenges and needs, researchers can understand what support would actually help. This information can guide doctors and dietitians to provide better care and education.

This study has some strengths: it used a validated food questionnaire that experts trust, it included people from multiple clinics, and it asked detailed questions about real-world challenges. However, only about half of the people invited actually participated, so the results might not represent all people with type 1 diabetes. Also, because people filled out surveys themselves, their answers might not be perfectly accurate—people sometimes forget what they ate or estimate differently than they actually do.

What the Results Show

The study found that people with type 1 diabetes are eating an average of 183 grams of carbohydrates per day. While this amount seems reasonable, the way people manage it is challenging. About 51% of participants said they find carbohydrate counting difficult or confusing. Even more concerning, 53% of people just estimate how many carbohydrates they’re eating by looking at their food, rather than measuring carefully. Only 18% use advanced methods like apps or scales to count accurately.

When it comes to other nutrients, the study found problems. People were eating only 23 grams of fiber per day when guidelines recommend more. They were also eating 29 grams of saturated fat per day, which is higher than recommended. These numbers suggest that many people with type 1 diabetes aren’t eating as healthily as they could be.

The research also revealed that many people are avoiding or limiting carbohydrate-rich foods. About 48% said they eat fewer carbohydrates than they probably should, and 61% avoid certain carbohydrate foods because they worry about blood sugar spikes. This suggests people might be making food choices based on fear rather than good nutrition information.

An important finding was about access to professional help. About 40% of people said they haven’t received enough dietary guidance from their healthcare team since they were diagnosed. One-third of participants (33%) said they would like more support from a dietitian. Interestingly, 39% believed that making changes to their diet could improve their blood sugar control, suggesting they recognize the importance of nutrition but may not know exactly how to do it.

These findings match what other studies have shown about people with type 1 diabetes. Previous research has also found that carbohydrate counting is one of the biggest challenges people face. The low fiber intake and high saturated fat intake are also consistent with what researchers have found in other countries. However, this study is valuable because it specifically looks at Swedish adults and shows that these challenges exist even in countries with good healthcare systems.

The study only included people from three clinics in Sweden, so results might be different in other countries or regions. Only about half of the people invited actually participated, which means the results might not represent everyone with type 1 diabetes. People filled out surveys themselves, so their answers about what they eat might not be completely accurate—people often forget details or estimate differently than reality. The study is also a snapshot in time, so we don’t know if these challenges change over time or if they’re temporary.

The Bottom Line

If you have type 1 diabetes, consider asking your healthcare team for a referral to a registered dietitian who specializes in diabetes. A dietitian can teach you practical ways to count carbohydrates that work for your lifestyle. Try to gradually increase your fiber intake by eating more vegetables, whole grains, and beans. Work with your healthcare team to find a carbohydrate counting method that feels manageable—it doesn’t have to be perfect to be helpful. These recommendations are supported by the study’s findings that people want more help and believe diet changes could improve their blood sugar control.

This research is most relevant for adults with type 1 diabetes who struggle with managing their diet and blood sugar. It’s also important for healthcare providers, dietitians, and diabetes educators who want to understand what challenges their patients face. Family members of people with type 1 diabetes may also benefit from understanding these challenges. This research is less relevant for people with type 2 diabetes, though some findings may apply.

Improving carbohydrate counting skills and eating habits takes time. You might notice better blood sugar stability within a few weeks of working with a dietitian, but developing new eating habits usually takes 2-3 months. Long-term improvements in fiber intake and saturated fat reduction may take several months to show up in blood work, but the benefits to your overall health are worth the effort.

Want to Apply This Research?

  • Track your daily carbohydrate intake and blood sugar readings together for one week to see patterns. Use the app to log what you eat and your blood sugar numbers at the same time, then review the data to identify which foods or carbohydrate amounts lead to better blood sugar control for you personally.
  • Set a goal to use one specific carbohydrate counting method consistently (such as the app’s food database, a scale, or visual portion guides). Start with just one meal per day, then gradually expand to other meals as it becomes easier. This builds confidence without feeling overwhelming.
  • Every two weeks, review your carbohydrate counting accuracy by comparing what you logged to what you actually ate. Track your time in range (the percentage of time your blood sugar is in your target zone) monthly to see if better carbohydrate management is helping. Share these trends with your healthcare team during regular check-ups to adjust your insulin doses if needed.

This research describes challenges that many people with type 1 diabetes face, but individual experiences vary. The findings suggest that working with a dietitian may be helpful, but this study doesn’t prove that dietary changes alone will improve blood sugar control for everyone. Always work with your healthcare team before making significant changes to your diet or insulin doses. This information is educational and should not replace personalized medical advice from your doctor or diabetes care team.