Summary

Challenge

Educating patients on calculating the carbohydrate in their food and drink can be complex. They need to understand food groups, know which foods are rapidly or slowly absorbed, be able to read food labels and know how to accurately estimate by sight or by weighing food.  Engagement of younger adults and children can be difficult, as it adds an extra, unwanted, process into their diabetes management.

The Carbs & Cals work was prompted by the realisation that many people with diabetes struggle with numeracy when calculating carbohydrate, failing to engage with the process, which they see as complicated and time consuming.

All commercially available public resources on carbohydrate counting to date had been based on lists of foods.

Objectives

The main objective was to improve people’s lives by making carbohydrate and calorie counting accessible and easily understood. The goal was to produce products that help people gain an understanding of nutrition in the most accessible way possible.

In order to help reach these goals, the team behind Carbs & Cals fostered relationships with national charities and international businesses to both strengthen their goals and broaden the reach of the number of people with diabetes they could help.

They also supported healthcare professionals on a national level to make dietary consultations easier and more effective, providing the tools needed to empower their patients, leading to clear improvements in health outcomes.

Solution

A long and extremely laborious process of taking test photographs and making design mock-ups took place.  People with diabetes provided feedback on the designs, as did healthcare professionals working within diabetes teams in the NHS.

To get added exposure and to ensure the information in the book was trusted, the team worked with Diabetes UK and the charity undertook quality assurance on the book.

Taking photos and performing nutritional analysis on the recipes and foods within the book took a year. A publishing company was set up, and the first books printed in March 2010.  An iPhone app was launched the same year.

Subsequent editions of the book have been released, following feedback from healthcare professionals and patients. The app has also been updated and a number of teaching resources developed. Free downloadable resources are available online.

Learnings

The key learning from making the Carbs & Cals products is to try and aim for simplicity in presenting information to people. This allows information to be more widely available to a range of ages and abilities. It also enables healthcare professionals to explain complex information.

Working with other organisations has also been key in sharing the resources with as many people with diabetes as possible. Being able to build and grow these networks has been a key driver to the success of the products.

Evaluation

Most UK healthcare professionals working in secondary care diabetes centres have heard of Carbs & Cals and use the book on a daily basis.  This is a testament to the geographical spread of its success. It is rare for any book to be in the top 100 on Amazon for more than a few months, yet Carbs & Cals has been there for the last four years.

The products have also been made available in other countries.  There have been worldwide orders for the UK books and app, and country-specific books produced for Portugal and the US. Italian and German books are in production.

Several NHS organisations are using images from the books for research in diabetes and cystic fibrosis.