PMID- 29344829
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210421
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 9
IP  - 1
DP  - 2018 Feb
TI  - Rapid-acting and Regular Insulin are Equal for High Fat-Protein Meal in 
      Individuals with Type 1 Diabetes Treated with Multiple Daily Injections.
PG  - 339-348
LID - 10.1007/s13300-017-0364-2 [doi]
AB  - INTRODUCTION: The fat and protein content can impact late postprandial glycemia; 
      therefore, prolonged insulin boluses for high-fat/-protein meals are recommended 
      for patients with type 1 diabetes on insulin pump therapy. It is not clear how to 
      translate these findings to multiple daily injection (MDI) therapy. We 
      hypothesized that regular insulin with a slower onset and a longer duration of 
      action might be advantageous for such meals. METHODS: Twenty-five patients with 
      well-controlled type 1 diabetes (mean HbA1c 6.8%, 51 mmol/mol, no episodes of 
      hypoglycemia) on MDI therapy, aged 27.9 +/- 4.3 years and well trained in flexible 
      intensive insulin therapy, were given three test breakfasts with the same 
      carbohydrate (CHO) content. The amount of fat and protein was low (LFP) or high 
      (HFP). For LFP meals, patients received a rapid-acting insulin; for HFP meals, a 
      rapid-acting or regular insulin was given in individual doses according to the 
      CHO content and individual insulin-CHO ratios. Postprandial glycemia was 
      determined by 6-h continuous glucose monitoring. RESULTS: Acute postprandial 
      glucose levels measured for 2 h were similar after LFP and two HFP meals 
      (7.8 +/- 2.0, 8.1 +/- 2.1, 8.0 +/- 1.9 mmol/l). Late postprandial glycemia measured 
      from 2 to 6 h was significantly lower after the LFP meal (6.7 +/- 1.8 mmol/l, 
      p < 0.05) than after the HFP meals, but there was no difference between the 
      rapid-acting or regular insulin on HFP days (8.6 +/- 2.6 and 8.9 +/- 2.8 mmol/l, NS). 
      CONCLUSION: The preliminary results of this study indicate no benefit to cover 
      fat-protein meals with regular insulin in individuals with type 1 diabetes 
      treated with MDI.
FAU - Jablonska, Karolina
AU  - Jablonska K
AD  - Department of Diabetology and Internal Medicine, Pomeranian Medical University in 
      Szczecin, Police, Poland.
FAU - Moleda, Piotr
AU  - Moleda P
AUID- ORCID: 0000-0002-1148-5483
AD  - Department of Diabetology and Internal Medicine, Pomeranian Medical University in 
      Szczecin, Police, Poland. pmoleda@wp.pl.
FAU - Safranow, Krzysztof
AU  - Safranow K
AD  - Department of Biochemistry and Medical Chemistry, Pomeranian Medical University 
      in Szczecin, Szczecin, Poland.
FAU - Majkowska, Lilianna
AU  - Majkowska L
AD  - Department of Diabetology and Internal Medicine, Pomeranian Medical University in 
      Szczecin, Police, Poland.
LA  - eng
PT  - Journal Article
DEP - 20180117
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC5801250
OTO - NOTNLM
OT  - Fat-protein meal
OT  - Insulin
OT  - Multiple daily injection therapy
OT  - Type 1 diabetes
EDAT- 2018/01/19 06:00
MHDA- 2018/01/19 06:01
PMCR- 2018/01/17
CRDT- 2018/01/19 06:00
PHST- 2017/11/06 00:00 [received]
PHST- 2018/01/19 06:00 [pubmed]
PHST- 2018/01/19 06:01 [medline]
PHST- 2018/01/19 06:00 [entrez]
PHST- 2018/01/17 00:00 [pmc-release]
AID - 10.1007/s13300-017-0364-2 [pii]
AID - 364 [pii]
AID - 10.1007/s13300-017-0364-2 [doi]
PST - ppublish
SO  - Diabetes Ther. 2018 Feb;9(1):339-348. doi: 10.1007/s13300-017-0364-2. Epub 2018 
      Jan 17.