Postprandial capillary-venous glucose gradient in Type 1 diabetes: magnitude and clinical associations in a real world setting
| Autor: | Helen Lunt, H. Chan, J. Berkeley, Helen F. Heenan, I. Lee, Chris Frampton |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Veins 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Research: Care Delivery Internal medicine Diabetes mellitus Internal Medicine medicine Dietary Carbohydrates Ingestion Humans Hypoglycemic Agents Insulin Care Delivery Research Articles Aged Aged 80 and over Type 1 diabetes Meal Blood Specimen Collection business.industry Venous Plasma Middle Aged medicine.disease Postprandial Period Capillaries Postprandial Diabetes Mellitus Type 1 Female Sample collection business |
| Zdroj: | Diabetic Medicine |
| ISSN: | 1464-5491 |
| Popis: | Aims To determine the magnitude of the peripheral glucose gradient in patients with Type 1 diabetes in a real world setting and to explore its relationship with insulin dose and macronutrient intake. Methods All patients used mealtime analogue insulin. The glucose gradient was assessed using antecubital fossa venous and finger‐stick capillary samples, collected concurrently at room temperature. Baseline sampling occurred before the administration of an insulin dose and breakfast of the patient's choosing. Breakfast was consumed an average of 15 min after baseline. The macronutrient content of breakfast was documented. Sampling was repeated 1 and 2 h after baseline. Results The mean (95% CI) plasma capillary–venous glucose gradient values for 43 patients were: pre‐breakfast, 0.21 (0.08–0.34) mmol/l; 1 h after baseline, 0.87 (0.66–1.07) mmol/l; and 2 h after baseline, 0.52 (0.33–0.71) mmol/l. Glucose gradient and dietary carbohydrate intake (g/kg body weight) were positively correlated at both 1 h (P < 0.01) and 2 h after baseline (P < 0.01). No relationship was observed between this gradient and mealtime insulin dose, or the glucose concentration at either time point. Conclusions In patients with Type 1 diabetes, a clinically significant glucose gradient is present after the ingestion of a carbohydrate‐rich meal. As postprandial capillary and venous plasma glucose concentrations are not equivalent, defining the site of sample collection is important. What's new? This report details the magnitude of the postprandial capillary–venous glucose gradient and its clinical associations, in patients with Type 1 diabetes.At 1 h from baseline, the capillary–venous glucose gradient was 0.87 mmol/l.A positive association was seen between the postprandial glucose gradient and carbohydrate intake.No association was seen with either preprandial insulin dose or baseline glucose concentration.Study findings suggest that when a postprandial glucose concentration is within the biochemical hypoglycaemia range, the site of glucose sampling should be clarified to allow appropriate clinical interpretation of the result. |
| Databáze: | OpenAIRE |
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