Aims Postprandial glycaemic variability carries on being a clinical challenge in optimizing glucose control in type 1 diabetes. The aim of this study was to compare the postprandial glycaemic effects of carbohydrate counting and food insulin index algorithms following the consumption of protein‐rich, high‐fat meals with different glycaemic index (GI) in adolescents with type 1 diabetes. Methods A randomized, single‐blind and crossover trial included 15 adolescents aged 14–18 years with type 1 diabetes. Participants consumed two different test meals with similar energy, macronutrients and food insulin index but the approximately twofold difference in GI, in random order on four consecutive mornings at their home. Insulin dose for high‐ and low‐GI test meals was determined by using the carbohydrate counting and food insulin index algorithms. Four‐hour postprandial glycaemia was assessed by the continuous glucose monitoring system. Results Compared with carbohydrate counting, the food insulin index algorithm significantly decreased peak glucose excursion (−57%, p = 0.02), incremental area under the curve (−65%, p = 0.02) and coefficient variation of blood glucose (−37%, p = 0.03) in the high‐GI meal, though there was no difference between the two algorithms in the low‐GI meal. The occurrence of hypoglycaemia did not significantly differ between insulin dosing algorithms for the high‐GI (p = 0.58) and low‐GI (p = 0.20) meals. Conclusions The food insulin index algorithm may be beneficial for postprandial glycaemic control after the consumption of high‐GI meals in adolescents with type 1 diabetes.

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Objective: We aimed to investigate a possible role of the endocrine disruptors phthalates, di-2-ethylhexyl phthalate (DEHP) and mono ( 2-ethylhexyl ) phthalate (MEHP), in polycystic ovary syndrome (PCOS) aetiopathogenesis. We also wished to evaluate the relationship between phthalates and metabolic disturbances in adolescents with PCOS. Methods: A total of 124 adolescents were included. Serum MEHP and DEHP levels were determined by high-performance liquid chromatography. Insulin resistance was evaluated using homeostasis model assessment-insulin resistance, quantitative Insulin Sensitivity Check Index, fasting glucose/insulin ratio, Matsuda index, and total insulin levels during oral glucose tolerance test. Participants were further subdivided into lean and obese subgroups according to body mass index (BMI). Results: Sixty-three PCOS and 61 controls, (mean age 15.2±1.5; range: 13-19 years) were enrolled. Serum DEHP and MEHP concentrations were not significantly different between PCOS and control groups. The mean (95% confidence interval) values of DEHP and MEHP were 2.62 (2.50-2.75) μg/mL vs 2.71 (2.52-2.90) μg/mL and 0.23 (0.19-0.29) μg/mL vs 0.36 (0.18-0.54) μg/mL in PCOS and the control groups respectively, p>0.05. Correlation analysis, adjusted for BMI, showed that both phthalates significantly correlated with insulin resistance indices and serum triglycerides in adolescents with PCOS. Conclusion: Serum DEHP and MEHP concentrations were not different between adolescents with or without PCOS. However, these phthalates are associated with metabolic disturbances such as dyslipidemia and insulin resistance, independently of obesity, in girls with PCOS.

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