BACKGROUND: In the present study, we tested the hypothesis that calories consumed at a prior meal (lunch) may impair glycemic control after a subsequent meal (supper) even if the pre-supper glucose did not differ regardless of the size of the lunch meal. METHODS:Nine subjects with Type 1 diabetes using continuous subcutaneous (s.c.) insulin infusion (CSII) therapy were studied on two separate days. Lunch (1200 h) was randomly assigned as 25% or 50% of the usual daily intake on alternate study days. The CSII was stopped at 1000 h on the day of the study and glucose was controlled until supper by adjusting the rate of intravenous (i.v.) insulin based on glucose measurements every 15 min. The CSII was restarted 1 h before supper and i.v. insulin discontinued 15 min before the first bite of supper. An identical supper meal and pre-supper s.c. bolus of short-acting insulin were administered on both visits. RESULTS:Pre-supper glycemia was nearly identical on each of the two study days. However, the post-supper glucose area under the curve was 27.5% greater on the day of the antecedent large lunch compared with the small lunch (P = 0.0039). CONCLUSIONS: For optimal postprandial glucose control, people with Type 1 diabetes may need to consider not only anticipated meal calories, but also prior food intake, a practice not commonly recommended based on currently used insulin dosing algorithms.
RCT Entities:
BACKGROUND: In the present study, we tested the hypothesis that calories consumed at a prior meal (lunch) may impair glycemic control after a subsequent meal (supper) even if the pre-supper glucose did not differ regardless of the size of the lunch meal. METHODS: Nine subjects with Type 1 diabetes using continuous subcutaneous (s.c.) insulin infusion (CSII) therapy were studied on two separate days. Lunch (1200 h) was randomly assigned as 25% or 50% of the usual daily intake on alternate study days. The CSII was stopped at 1000 h on the day of the study and glucose was controlled until supper by adjusting the rate of intravenous (i.v.) insulin based on glucose measurements every 15 min. The CSII was restarted 1 h before supper and i.v. insulin discontinued 15 min before the first bite of supper. An identical supper meal and pre-supper s.c. bolus of short-acting insulin were administered on both visits. RESULTS: Pre-supper glycemia was nearly identical on each of the two study days. However, the post-supper glucose area under the curve was 27.5% greater on the day of the antecedent large lunch compared with the small lunch (P = 0.0039). CONCLUSIONS: For optimal postprandial glucose control, people with Type 1 diabetes may need to consider not only anticipated meal calories, but also prior food intake, a practice not commonly recommended based on currently used insulin dosing algorithms.
Entities:
Keywords:
blood glucose; diet; insulin; insulin infusion systems
Authors: A Virkamäki; E Korsheninnikova; A Seppälä-Lindroos; S Vehkavaara; T Goto; J Halavaara; A M Häkkinen; H Yki-Järvinen Journal: Diabetes Date: 2001-10 Impact factor: 9.461
Authors: A Maretha Opperman; Christina S Venter; Welma Oosthuizen; Rachel L Thompson; Hester H Vorster Journal: Br J Nutr Date: 2004-09 Impact factor: 3.718