- Title
- For a high fat, high protein breakfast, preprandial administration of 125% of the insulin dose improves postprandial glycaemic excursions in people with type 1 diabetes using multiple daily injections: A cross-over trial
- Creator
- Smith, Tenele A.; Smart, Carmel E.; Howley, Peter P.; Lopez, Prudence E.; King, Bruce R.
- Relation
- Diabetic Medicine Vol. 38, Issue 7, no. e14512
- Publisher Link
- http://dx.doi.org/10.1111/dme.14512
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2021
- Description
- Aim: To determine the glycaemic impact of an increased insulin dose, split insulin dose and regular insulin for a high fat, high protein breakfast in people with type 1 diabetes using multiple daily injections (≥4/day). Methods: In this cross-over trial, participants received the same high fat, high protein breakfast (carbohydrate:30 g, fat:40 g, protein:50 g) for 4 days. Four different insulin strategies were randomly allocated and tested; 100% of the insulin-to-carbohydrate ratio (ICR) given in a single dose using aspart insulin (100Asp), 125% ICR given in a single dose using aspart (125Asp) or regular insulin (125Reg) and 125% ICR given in a split dose using aspart insulin (100:25Asp). Insulin was given 0.25 hr pre-meal and for 100:25Asp, also 1 hr post-meal. Postprandial sensor glucose was measured for 5 hr. Results: In all, 24 children and adults were participated. The 5-hr incremental area under the curves for 100Asp, 125Asp, 125Reg and 100:25Asp were 620 mmol/L.min [95% CI: 451,788], 341 mmol/L.min [169,512], 675 mmol/L.min [504,847] and 434 mmol/L.min [259,608], respectively. The 5-hr incremental area under the curve for 125Asp was significantly lower than for 100Asp (p = 0.016) and for 125Reg (p = 0.002). There was one episode of hypoglycaemia in 125Reg. Conclusions: For a high fat, high protein breakfast, giving 125% ICR preprandially, using aspart insulin significantly improved postprandial glycaemia without hypoglycaemia. There was no additional glycaemic benefit from giving insulin in a split dose (100:25%) or replacing aspart with regular insulin.
- Subject
- children and adolescents; endocrinology; insulin therapy; nutrition and diet; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1474655
- Identifier
- uon:49334
- Identifier
- ISSN:0742-3071
- Language
- eng
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