Benefit of supplementary fat plus protein counting as compared with conventional carbohydrate counting for insulin bolus calculation in children with pump therapy
| Autor: | Evelin Sadeghian, Olga Kordonouri, Sarah Bläsig, Reinhard Hartmann, Thomas Danne, K Remus |
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| Rok vydání: | 2012 |
| Předmět: |
Type 1 diabetes
medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism Insulin medicine.medical_treatment Area under the curve medicine.disease Crossover study Carbohydrate counting Bolus (medicine) Postprandial Endocrinology Internal medicine Pediatrics Perinatology and Child Health Internal Medicine medicine business Postprandial Hypoglycemia |
| Zdroj: | Pediatric Diabetes. 13:540-544 |
| ISSN: | 1399-543X |
| DOI: | 10.1111/j.1399-5448.2012.00880.x |
| Popis: | Objective To investigate carbohydrate (CARB) and supplementary fat/protein (CFP) counting using normal and dual-wave bolus in pump therapy of children and young people with type 1 diabetes (T1D). Study design and methods A randomized clinical trial was conducted in 42 patients (age 6–21 yr) with T1D for at least 1 yr (5.2 ± 3.1 yr, mean ± SD) and pump therapy for at least 3 months (3.3 ± 1.8 yr). Standardized test meals (pizza-salami; 50% carbohydrate, 34% fat, 16% protein; corresponding to 33% of age-adjusted daily energy requirement) were given at lunch time on four different days with normal and dual-wave bolus using CARB and CFP counting in a randomized sequence. Sensor-augmented pumps were used for continuous glucose monitoring of 6-h postprandial glucose profiles. Intra-individual comparisons of glucose parameters [area under the curve (AUC) mg/dL ×6 h; average glucose, AV mg/dL] were performed. Results Using CFP counting, 6-h postprandial glucose AUC (805 ± 261) and AV (137.8 ± 46.2) were significantly lower than AUC (926 ± 285) and AV (160.5 ± 51.9) by CARB counting (p < 0.001, each). CFP counting led to significantly lower postprandial glucose parameters independently from the kind of bolus (normal bolus: ΔAUC 169, p < 0.001; ΔAV 30.6, p < 0.001/dual-wave bolus: ΔAUC 73, p = 0.045, ΔAV 14.8, p = 0.033). Postprandial hypoglycemia episodes ( |
| Databáze: | OpenAIRE |
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