Administering a small rapid-acting insulin bolus 3 h after eating a mixed macronutrient meal improves postprandial glucose control, without hypoglycaemia, in people with Type 1 diabetes

Campbell, Matthew, Walker, Mark, King, D., Allerton, Dean, Shaw, James, Luzio, Stephen, Dunseath, Gareth, Bracken, Richard, Stevenson, Emma and West, Dan (2016) Administering a small rapid-acting insulin bolus 3 h after eating a mixed macronutrient meal improves postprandial glucose control, without hypoglycaemia, in people with Type 1 diabetes. In: Diabetes UK Professional Conference 2016, 2nd - 4th March 2016, Glasgow, UK.

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Abstract

Aims: To establish an optimal rapid-acting bolus insulin dose and administration timing strategy to improve postprandial glycaemia after mixed macronutrient meals in people with Type 1 diabetes treated with basal bolus insulin injections.

Methods: Ten males [HbA1c 7.0±0.5% (52.5±5.9 mmol/ mol)] attended the laboratory at 07:30 h on four occasions and underwent (1) a low fat meal with bolus insulin dictated by carbohydrate counting (low-fat100%), (2) a high fat meal with bolus insulin dictated by carbohydrate counting (high fat100%), (3) a high fat meal with a bolus insulin dose increased by 30% (high-fat130%), (4) a high fat meal with bolus insulin dictated by carbohydrate counting, with an additional 30% administered at 3 h post-meal (high-fatsplit). Meals were matched for carbohydrate and protein content. Blood samples were collected periodically over a 6h postprandial period and were processed for glucose, insulin, triglycerides, TNF-a, fibrinogen and tissue factor pathway.

Results: Blood glucose area under the curve was similar between low-fat100% and high-fatsplit; however, high-fat100% and high-fat130% were significantly higher, and lower, respectively. During the 6h postprandial period, 60% of patients under high fat130% experienced hypoglycaemia, with no incidences under the other conditions. There were no conditional differences in the lipaemic, inflammatory or pro-coagulant markers.

Conclusions: When a carbohydrate meal with a large fat content is consumed, using the carbohydrate counting method for insulin dose adjustments at mealtime and administering a small insulin bolus 3h later provides similar postprandial glucose control to a meal containing negligible fat. This strategy is not associated with hypoglycaemia or metabolic disturbances.

Item Type:	Conference or Workshop Item (Poster)
Subjects:	B400 Nutrition C600 Sports Science
Department:	Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User:	Paul Burns
Date Deposited:	11 Apr 2016 11:50
Last Modified:	12 Oct 2019 12:13
URI:	http://nrl.northumbria.ac.uk/id/eprint/26523

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