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BackgroundThe present study investigated the effects of fat‐protein (CFP) counting in addition to carbohydrate (CARB) counting for calculating prandial insulin dosage on blood glucose profile in patients with type 1 diabetes (T1D) on basal‐bolus insulin therapy.MethodsIn this single centre, cross‐over, randomised, controlled study, control meal (SM: standard meal using a carbohydrate counting method) and three test meals (HPM: high protein meal using a carbohydrate counting method; HPFM‐a: high protein‐fat meal using a carbohydrate counting method; HPFM‐b: high protein‐fat meal using a carbohydrate and fat‐protein counting method) were compared on postprandial early (0–120 min), late (120–240 min) and total (0–240 min) glucose response in 30 patients with T1D, aged 16–18 years.ResultsThe glucose levels of 0–90 min did not change after different meal consumptions (P > 0.05), whereas 120–240 min glucose levels were higher after HPFM‐a consumption compared to HPFM‐b consumption (P < 0.05). There were no significant differences between meals with respect to the early postprandial glucose response (0–120 min) (P = 0.405). In late response (120–240 min), HPFM‐b [area under the curve (AUC) = 20 609 (582) mg dL−1 × dk] was significantly lower than SM [AUC = 24 092 (9015) mg dL−1 × dk], HPM [AUC = 24 072 (5853) mg dL−1 × dk] and HPFM‐a [AUC = 25 986 (6979) mg dL−1 × dk] (P = 0.032).ConclusionsMeal‐related insulin dosing based on carbohydrate plus fat/protein counting has given positive results in the postprandial glycaemic profile as a result of lower postprandial glycaemic levels compared to conventional carbohydrate counting in patients with T1D after a high protein‐fat meal.

IntroductionIn PKU there is little data comparing the prevalence of overweight and obesity in different countries. The aim of this cross sectional study was to evaluate prevalence data from different PKU treatment centres in Europe and Turkey.Subjects and methodsIn children, body mass index (BMI) and z scores and in adults BMI were calculated in 947 patients (783 children aged < 19 years; 164 adults aged ≥ 19 years) with PKU from centres in Europe and Turkey (Ankara, Birmingham, Brussels, Copenhagen, Groningen, Madrid, Munich and Porto).ResultsIn adults with PKU, 83% of centres (n = 5/6) had less overweight than the general populations but 83% (n = 5/6) had a higher rate of female obesity. In childhood, all centres reported obesity rates within or similar to local population ranges in boys but in 57% (n = 4/7) of centres a higher rate of obesity in girls. The percentage of overweight and obesity increased with age.DiscussionIn PKU, it is clear from a number of treatment centres that women and girls with PKU appear particularly vulnerable to excess weight gain and it is important that female weight gain is closely monitored and individual strategies introduced to prevent excess weight gain. Overall, in PKU there is a need to understand better the food patterns and activity levels of patients.

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