Glycaemic load versus carbohydrate counting for insulin bolus calculation in patients with type 1 diabetes on insulin pump

Bozzetto, Lutgarda; Giorgini, Marisa; Alderisio, Antonio; Costagliola, L.; Giacco, Antonia; Riccardi, Gabriele; Rivellese, Angela Albarosa; Annuzzi, Giovanni

doi:10.1007/s00592-015-0716-1

Cited by 26 publications

(20 citation statements)

References 16 publications

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“…On the other hand, in the late postprandial period, blood glucose values increased after the LGI meals, while they tended to return to baseline after the HGI meals. These findings extend previous knowledge obtained in studies in which the observation time was often limited to 3-4 h after the meal (5,(23)(24)(25) and draw attention to the limits of the definition of glycemic index that is generally calculated based on the first 2-3 h after meal. Moreover, if confirmed in future studies, these findings might have important clinical implications in relation to the timing of premeal insulin administration concerning the use of different modalities of insulin infusion (23) (e.g., dual-wave bolus) or insulin with different absorption kinetics (24), as well as modulating the amount of insulin injected according to the type of carbohydrate foods of the meal (5).…”

Section: Discussionsupporting

confidence: 86%

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Extra-Virgin Olive Oil Reduces Glycemic Response to a High–Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial

et al. 2016

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OBJECTIVETo evaluate whether fat quality, in the context of meals with high-(HGI) or lowglycemic index (LGI), influences postprandial blood glucose (PPG) response in patients with type 1 diabetes. RESEARCH DESIGN AND METHODSAccording to a randomized crossover design, 13 patients with type 1 diabetes on insulin pump consumed two series (HGI or LGI) of meals with the same carbohydrate quantity while differing for amount and quality of fat: 1) low in fat ("low fat"), 2) high in saturated fat (butter), or 3) high in monounsaturated fat (extra-virgin olive oil) (EVOO). Premeal insulin doses were based on insulinto-glycemic load ratios. Continuous glucose monitoring was performed and 6-h PPG evaluated. RESULTSPPG was significantly different between HGI and LGI meals (P = 0.005 for time 3 glycemic index interaction by repeated-measures analysis [RMA]), being significantly higher during the first 3 h after the HGI meals with a later tendency to an opposite pattern. In the context of HGI meals, PPG was significantly lower after EVOO than after low fat or butter (P < 0.0001 for time 3 meal interaction by RMA), with a marked difference in the 0-to 3-h glucose incremental area under the curve between EVOO (mean 6 SD 198 6 274 mmol/L 3 180 min) and either low fat (416 6 329) or butter (398 6 355) (P < 0.05). No significant differences were observed in PPG between the three LGI meals. CONCLUSIONSCarbohydrate quality of a mixed meal influences shape and extent of PPG. Besides, using EVOO in a HGI meal attenuates the early postprandial glucose response observed when this meal is consumed with either low fat or butter. Therefore, an optimal prandial insulin administration would require considering, in addition to the quantity of carbohydrates, the quality of both carbohydrate and fat.

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Section: Discussionsupporting

confidence: 86%

“…We recently observed in a real-life setting that calculating premeal insulin doses on the basis of the glycemic loaddi.e., taking into account both quality and quantity of carbohydratesdimproves daily blood glucose profile compared with considering only the quantity of carbohydrates (5).…”

mentioning

confidence: 99%

Extra-Virgin Olive Oil Reduces Glycemic Response to a High–Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial

et al. 2016

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“…Ancak, karbonhidrat tipinin de insülin ihtiyacına ve dağılımına etki edebileceği belirtilmektedir. 2,33,34 Gİ, karbonhidrat içeren besinlerin kan glukozunu yükseltme potansiyellerine dayanan bir sıra-lama sistemidir. 30 Glisemik yük (GY) ise besinin yenilen miktarının kan glukozuna etkisini göste-ren bir ölçümdür.…”

Section: Gli̇semi̇k İndeksi̇n Postprandi̇yal Gli̇semi̇ üZeri̇ne Etki̇si̇unclassified

The Effect of Fat, Protein and Glycemic Index on Blood Glucose in Type 1 Diabetes and Their Usage in Insulin Administration: Review

Bozbulut¹,

Şanlıer²

2016

Turkiye Klinikleri J Endocrin

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“…Em comparação ao método de contagem de carboidratos, o uso do método de contagem da CG apresentou menor variabilidade pós-prandial da glicose em indivíduos com DM tipo 1 [12]. Além disso, dietas com alto IG e CG são associadas ao aumento do risco de desenvolvimento de doença arterial coronariana em indivíduos diabéticos [11].…”

Section: Introductionunclassified

“…Além disso, dietas com alto IG e CG são associadas ao aumento do risco de desenvolvimento de doença arterial coronariana em indivíduos diabéticos [11]. Dessa forma, a utilização do IG e da CG pode trazer benefícios adicionais aos indivíduos com DM, quando o total de carboidratos da refeição é contabilizado [10][11][12].…”

Section: Introductionunclassified

Determinação do índice glicêmico e da carga glicêmica de dietas hospitalares servidas para diabéticos

Lemos

Patek

Mezzomo

2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACTAIMS: To determine the glycemic index and the glycemic load of diets usually offered by hospitals to patients with diabetes mellitus. METHODS: A cross-sectional study evaluated menus served to diabetic inpatients of hospitals in the city of Curitiba, Parana, Brazil. Analyzing the menus, we determined the energy content, macronutrients, glycemic index and glycemic load of the meals offered to the patients. RESULTS: Five general hospitals of the city participated in the study and 10 menus for diabetes were evaluated. The structure of the menus was different mainly in the quantitative supply of fruits and milk. Diets ranged from 1317.6 to 2013.2 kcal, with 18.9 to 27.6% of proteins, 21.9 to 29.4% of lipids, 48.2 to 53.3% of carbohydrates and 24.7 to 33.6 g of fibers. Daily glycemic index ranged from 47 to 57% and daily glycemic load from 81 to 109%. CONCLUSIONS: All offered diets were hyperproteic, normolipid and normoglicidic. However, inadequate levels of glycemic load were observed in all the evaluated menus, although with adequate levels of glycemic index. It is necessary to review the diet plans elaborated for diabetics, aiming at the best dietary treatment for this population.

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Glycaemic load versus carbohydrate counting for insulin bolus calculation in patients with type 1 diabetes on insulin pump

Abstract: Calculating prandial insulin bolus based on glycaemic load counting is feasible in a real-life setting and may improve postprandial glucose control in people with T1D.

Cited by 26 publications

References 16 publications

Extra-Virgin Olive Oil Reduces Glycemic Response to a High–Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial

Extra-Virgin Olive Oil Reduces Glycemic Response to a High–Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial

The Effect of Fat, Protein and Glycemic Index on Blood Glucose in Type 1 Diabetes and Their Usage in Insulin Administration: Review

Determinação do índice glicêmico e da carga glicêmica de dietas hospitalares servidas para diabéticos

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