Improving the Estimation of Meal-Time Insulin Dose Based On the Glycaemic Load of a Meal in Children with Type 1 Diabetes on Insulin Pump Therapy: A Randomized StudyLidia Groele1*, Dominik Golicki2, Marlena Blazik3 and Ewa Pankowska4
- *Corresponding Author:
- Lidia Groele
Department of Paediatrics
Medical University of Warsaw 01-184 Warsaw
Dzialdowska 1 str., Poland
Tel: 00 48 22 45 23 284
Fax: 00 48 22 45 23 309
E-mail: [email protected]
Received date: June 28, 2014; Accepted date: September 16, 2014; Published date: September 24, 2014
Citation: Groele L, Golicki D, Blazik M, Pankowska E (2014) Improving the Estimation of Meal-Time Insulin Dose Based On the Glycaemic Load of a Meal in Children with Type 1 Diabetes on Insulin Pump Therapy: A Randomized Study. J Diabetes Metab 5:435. doi: 10.4172/2155-6156.1000435
Copyright: © 2014 Groele L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The aim of the study was to assess whether an Insulin-Carbohydrate Ratio (ICR) increased by 30% per meal with a high glycaemic load allows postprandial glucose excursion to be maintained in control in children with type 1 diabetes.
Methods: A total of 70 children on insulin pump therapy participated in the study. They were stratified into age groups: 4-7 years of age, 8-12 years of age and above 12 years of age. The experimental Group (A) received an insulin dose based on individualised ICR increased by 30% for breakfast containing cornflakes with milk. The control group (B) received an insulin dose based on standard individualised ICR. The glycaemic load of the meal was adjusted to the age group (24,3; 32,4; 40,5). We assessed metabolic effects such as the area under the glucose curve (AUC), glucose increment, risk of hyperglycaemia and hypoglycaemia using two methods: blood glucose concentration (at 0, 15, 30, 45, 60, 90 and 120 minutes) and a continuous subcutaneous glucose measurement system (for 3 hours postprandially).
Results: A significant glucose rise was noted in the control group B (p=0.03). Over the postprandial 180 minutes, AUC was significantly lower (p=0.02) in the experimental group but only in children aged 8-12. The frequency of hypoglycaemic events was not statistically significant during postprandial observation (p=0.75).
Conclusion: Increasing the ICR by 30% for a meal with high GL can reduce the glucose excursion without increasing the risk of hypoglycaemia in children with type 1 diabetes treated with insulin pump therapy.