This site is intended for healthcare professionals only

Expressing carbohydrate ratios

Karen Ross, Frances Hanson

With a national drive for quality and consistency in paediatric diabetes education, this article reviews the differences in insulin:carbohydrate ratio (ICR) expression and how they are used in practice. Is one method superior to the other and how does technology support these methods of expression? Is it possible to standardise our approach in the UK?


Bangstad HJ, Danne T, Deeb LC et al (2009) Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 10(Suppl 12): 82–99
Barnard K, Parkin C (2012) Can automated bolus advisors help alleviate the burden of complex maths and lead to optimised diabetes health outcomes? Diabetes Care for Children & Young People 1: 6–9
Carpentieri JD, Litster J, Frumkin L (2009) Adult numeracy: A review of research. National Research and Development Centre for adult literacy and numeracy, London. Available at: (accessed 24.01.13)
Kordonouri O, Hartmann R, Remus K et al (2012) Benefit of supplementary fat plus protein counting as compared with conventional carbohydrate counting for insulin bolus calculation in children with pump therapy. Pediatr Diabetes 13: 540–4
Nutrition and Diet Resources UK (2010a) Introduction to carbohydrate counting. Workbook 1. NDR-UK, Glasgow
Nutrition and Diet Resources UK (2010b) Carbohydrate counting: The next steps. Workbook 2. NDR-UK, Glasgow
Pankowska E, Blazik M, Dziechciarz P et al (2009) Continuous subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: a systematic review and meta-analysis of randomized control trials. Pediatr Diabetes 10: 52–8
Pankowska E, Błazik M, Groele L (2012) Does the fat-protein meal increase postprandial glucose level in type 1 diabetes patients on insulin pump: the conclusion of a randomized study. Diabetes Technol Ther 14: 16–22
Phillip M, Battelino T, Rodriguez H et al (2007) Use of insulin pump therapy in the pediatric age-group. Consensus statement from the European Society for Paediatric Endocrinology, the Lawson Wilkins Pediatric Endocrine Society, and the International Society for Pediatric and Adolescent Diabetes, endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 30: 1653–62
Smart CE, Ross K, Edge JA et al (2009) Children and adolescents on intensive insulin therapy maintain postprandial glycaemic control without precise carbohydrate counting. Diabet Med 26: 279–85
Smart CE, Ross K, Edge JA et al (2010) Can children with Type 1 diabetes and their caregivers estimate the carbohydrate content of meals and snacks? Diabet Med 27: :348–53

For the latest news and articles

Sign up to all DiabetesontheNet journals

© Copyright Omniamed Communications. All Rights Reserved​
108 Cannon Street, London, EC4N 6EU. Registered in the United Kingdom​
Omniamed logo white
Free for all UK & Ireland healthcare professionals

Sign up to all DiabetesontheNet journals


By clicking ‘Subscribe’, you are agreeing that are able to email you periodic newsletters. You may unsubscribe from these at any time. Your info is safe with us and we will never sell or trade your details. For information please review our Privacy Policy.

DiabetesontheNet Logo

This website is for healthcare professionals only. To continue, please confirm that you are a healthcare professional below.