| In children using intensive insulin therapy, a 20-g variation in carbohydrate amount significantly impacts on postprandial glycaemia. | |
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MedLine Citation:
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PMID: 22268422 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aim: To determine if an insulin dose calculated for a meal containing 60 g carbohydrate maintains postprandial glycaemic control for meals containing 40, 50, 70 or 80 g carbohydrate. Methods: Thirty-four young people (age range 8.5-17.7 years) using intensive insulin therapy consumed five test breakfasts with equivalent fat, protein and fibre contents but differing carbohydrate quantities (40, 50, 60, 70 and 80 g of carbohydrate). The preprandial insulin dose was the same for each meal, based on the subject's usual insulin:carbohydrate ratio for 60 g carbohydrate. Continuous glucose monitoring was used to monitor postprandial glucose over 180 min. Results: The 40-g carbohydrate meal resulted in significantly more hypoglycaemia than the other meals (P = 0.003). There was a one in three chance of hypoglycaemia between 120 and 180 min if an insulin dose for 60 g carbohydrate was given for 40 g carbohydrate. The glucose levels of subjects on the 80-g meal were significantly higher than the 60- and 70-g carbohydrate meals at all time points between 150 and 180 min (P < 0.01). Subjects on the 80-g meal were more likely to have significant hyperglycaemia (blood glucose levels ≥ 12 mmol/l) compared with the other meals (P < 0.001). Conclusions: In patients using intensive insulin therapy, an individually calculated insulin dose for 60 g carbohydrate results in postprandial hypoglycaemia or hyperglycaemia for meals containing 40 and 80 g carbohydrate. To calculate mealtime insulin in order to maintain postprandial control, carbohydrate estimations should be within 10 g of the actual meal carbohydrate. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. |
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Authors:
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C E Smart; B R King; P McElduff; C E Collins |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-24 |
Journal Detail:
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Title: Diabetic medicine : a journal of the British Diabetic Association Volume: - ISSN: 1464-5491 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. |
Affiliation:
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John Hunter Children's Hospital, Department of Paediatric Endocrinology, Newcastle School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Rankin Park, NSW, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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