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Published Online: 4 January 2012

Does the Fat-Protein Meal Increase Postprandial Glucose Level in Type 1 Diabetes Patients on Insulin Pump: The Conclusion of a Randomized Study

Publication: Diabetes Technology & Therapeutics
Volume 14, Issue Number 1

Abstract

Background: Our study examines the hypothesis that in addition to sugar starch-type diet, a fat-protein meal elevates postprandial glycemia as well, and it should be included in calculated prandial insulin dose accordingly. The goal was to determine the impact of the inclusion of fat-protein nutrients in the general algorithm for the mealtime insulin dose calculator on 6-h postprandial glycemia.
Subjects and Methods: Of 26 screened type 1 diabetes patients using an insulin pump, 24 were randomly assigned to an experimental Group A and to a control Group B. Group A received dual-wave insulin boluses for their pizza dinner, consisting of 45 g/180 kcal of carbohydrates and 400 kcal from fat-protein where the insulin dose was calculated using the following algorithm: n Carbohydrate Units×ICR+n Fat-Protein Units×ICR/6 h (standard+extended insulin boluses), where ICR represents the insulin-to-carbohydrate ratio. For the control Group B, the algorithm used was n Carbohydrate Units×ICR. The glucose, C-peptide, and glucagon concentrations were evaluated before the meal and at 30, 60, 120, 240, and 360 min postprandial.
Results: There were no statistically significant differences involving patients' metabolic control, C-peptide, glucagon secretion, or duration of diabetes between Group A and B. In Group A the significant glucose increment occurred at 120–360 min, with its maximum at 240 min: 60.2 versus −3.0 mg/dL (P=0.04), respectively. There were no significant differences in glucagon and C-peptide concentrations postprandial.
Conclusions: A mixed meal effectively elevates postprandial glycemia after 4–6 h. Dual-wave insulin bolus, in which insulin is calculated for both the carbohydrates and fat proteins, is effective in controlling postprandial glycemia.

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Published In

cover image Diabetes Technology & Therapeutics
Diabetes Technology & Therapeutics
Volume 14Issue Number 1January 2012
Pages: 16 - 22
PubMed: 22013887

History

Published online: 4 January 2012
Published in print: January 2012
Published ahead of print: 20 October 2011

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Ewa Pańkowska, M.D., Ph.D.
Institute of the Mother and Child, Warsaw, Poland.
Marlena Błazik, M.D.
Institute of the Mother and Child, Warsaw, Poland.
Lidia Groele, M.D.
Warsaw Medical University, Warsaw, Poland.

Notes

Address correspondence to:Ewa Pańkowska, M.D., Ph.D.The Institute of Mother and ChildUl. Kapsrzaka 17A01-122 Warsaw,Poland
E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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