Diets for insulin pump and multiple daily injection therapy.

The role of diet in achieving and maintaining normalized blood glucose control in type I diabetic patients using insulin pumps or multiple daily injection (MDI) regimens is not well defined. We describe herein dietary guidelines that have proved effective in the management of such patients over 3 yr. The guidelines stress the importance of a careful dietary history, the regularity and consistency of diet during the preliminary adjustment period, the establishment of a variable insulin dosage schedule based on meal size and content as well as blood glucose, the appropriate treatment for hypoglycemia, and dietary adjustments for exercise. While insulin pump and MDI therapy may ultimately provide increased flexibility in certain aspects of dietary therapy, the diet must be carefully controlled if these innovative modes of insulin delivery are to succeed.