| Improving the Estimation of Mealtime Insulin Dose in Adults With Type 1 Diabetes: The Normal Insulin Demand for Dose Adjustment (NIDDA) study. | |
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MedLine Citation:
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PMID: 21949219 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE Although carbohydrate counting is routine practice in type 1 diabetes, hyperglycemic episodes are common. A food insulin index (FII) has been developed and validated for predicting the normal insulin demand generated by mixed meals in healthy adults. We sought to compare a novel algorithm on the basis of the FII for estimating mealtime insulin dose with carbohydrate counting in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 28 patients using insulin pump therapy consumed two different breakfast meals of equal energy, glycemic index, fiber, and calculated insulin demand (both FII = 60) but approximately twofold difference in carbohydrate content, in random order on three consecutive mornings. On one occasion, a carbohydrate-counting algorithm was applied to meal A (75 g carbohydrate) for determining bolus insulin dose. On the other two occasions, carbohydrate counting (about half the insulin dose as meal A) and the FII algorithm (same dose as meal A) were applied to meal B (41 g carbohydrate). A real-time continuous glucose monitor was used to assess 3-h postprandial glycemia. RESULTS Compared with carbohydrate counting, the FII algorithm significantly decreased glucose incremental area under the curve over 3 h (-52%, P = 0.013) and peak glucose excursion (-41%, P = 0.01) and improved the percentage of time within the normal blood glucose range (4-10 mmol/L) (31%, P = 0.001). There was no significant difference in the occurrence of hypoglycemia. CONCLUSIONS An insulin algorithm based on physiological insulin demand evoked by foods in healthy subjects may be a useful tool for estimating mealtime insulin dose in patients with type 1 diabetes. |
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Authors:
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Jiansong Bao; Heather R Gilbertson; Robyn Gray; Diane Munns; Gabrielle Howard; Peter Petocz; Stephen Colagiuri; Jennie C Brand-Miller |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetes care Volume: 34 ISSN: 1935-5548 ISO Abbreviation: Diabetes Care Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: United States |
Other Details:
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Languages: eng Pagination: 2146-51 Citation Subset: IM |
Affiliation:
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Corresponding author: Jennie C. Brand-Miller, jennie.brandmiller@sydney.edu.au. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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