The Effect of Prandial Insulin Applied for Fat Protein Units on
Postprandial Glucose Excursions in Type 1 Diabetes Patients with Insulin Pump
Therapy: Results of a Randomized, Controlled, Cross-Over Study
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Medientyp:
E-Artikel
Titel:
The Effect of Prandial Insulin Applied for Fat Protein Units on
Postprandial Glucose Excursions in Type 1 Diabetes Patients with Insulin Pump
Therapy: Results of a Randomized, Controlled, Cross-Over Study
Beschreibung:
<jats:title>Abstract</jats:title><jats:p>
Objective This randomized cross-over study aimed to compare different
algorithms for calculating prandial insulin considering the fat and protein
content of a standardized meal in type 1 diabetes patients using insulin pump
therapy (CSII).</jats:p><jats:p>
Methods Twenty-six patients received a standardized evening meal for three
consecutive days using different algorithms for insulin dose adjustment: A)
exclusive consideration of carbohydrate content without considering fat-protein
content, B) high-dose algorithm considering additional insulin for fat protein
units (FPUs) with the same factor as for carbohydrates, and C) low-dose
algorithm considering additional insulin for FPUs with half the factor as for
carbohydrates. The primary outcome was the proportion of interstitial glucose
values in the target range (≥ 70 to ≤ 180 mg/dl) during
the post-prandial 12-hour follow-up period. Secondary outcomes were the
occurrence of hypo- and hyperglycemic episodes and the coverage with
carbohydrates for treatment of hypoglycemia.</jats:p><jats:p>
Results The percentage of glucose values in the target range was
significantly higher when fat-protein content was not considered, whereas, in
the hyperglycemic range, it did not differ significantly among the three groups.
The percentage of hypoglycemic glucose values were the highest in the groups
considering fat-protein content and lowest in the group not considering FPUs
with no significant difference between the two groups in terms of FPUs.</jats:p><jats:p>
Conclusions In adult type 1 diabetes patients using CSII, it is not
recommended to consider a high fat and protein content in the diet when
calculating prandial insulin dosage with the selected algorithms, as this
increases the risk of hypoglycemia disproportionately.</jats:p>