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Effect of varying glycemic index meals on blood glucose control assessed with continuous glucose monitoring in youth with type 1 diabetes on basal-bolus insulin regimens.

ABSTRACT: OBJECTIVE:The purpose of this study was to test the effect of high glycemic index (HGI) and low glycemic index (LGI) meals on blood glucose levels using continuous blood glucose monitoring in youths with type 1 diabetes. RESEARCH DESIGN AND METHODS:A total of 20 youths on basal-bolus regimens consumed macronutrient-matched HGI and LGI meals 1 day each in a controlled setting in varying order following consumption of a standardized evening meal. Medtronic MiniMed Continuous Glucose Monitoring Systems were used to assess blood glucose (BG) profiles. RESULTS:Participants demonstrated significantly lower daytime mean BG, BG area >180 mg/dl, and high BG index when consuming LGI meals but no differences for daytime BG area <70 mg/dl, daytime low BG index, or any nighttime values. Significantly more BG values <80 mg/dl were treated on LGI days. CONCLUSIONS:Findings indicate that consumption of an LGI diet may reduce glucose excursions, improving glycemic control.

SUBMITTER: Nansel TR

PROVIDER: S-EPMC2367100 | biostudies-literature | 2008 Apr

REPOSITORIES: biostudies-literature

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Effect of varying glycemic index meals on blood glucose control assessed with continuous glucose monitoring in youth with type 1 diabetes on basal-bolus insulin regimens.

Nansel Tonja R TR Gellar Lauren L McGill Adrienne A

Diabetes care 20080117 4

<h4>Objective</h4>The purpose of this study was to test the effect of high glycemic index (HGI) and low glycemic index (LGI) meals on blood glucose levels using continuous blood glucose monitoring in youths with type 1 diabetes.<h4>Research design and methods</h4>A total of 20 youths on basal-bolus regimens consumed macronutrient-matched HGI and LGI meals 1 day each in a controlled setting in varying order following consumption of a standardized evening meal. Medtronic MiniMed Continuous Glucose ...[more]

PMID: 18202243

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Project description:BackgroundContinuous glucose monitors (CGMs) are being used to characterize postprandial glycemic responses and thereby provide personalized dietary advice to minimize glycemic excursions. However, the efficacy of such advice depends on reliable CGM responses.ObjectiveTo explore within-subject variability of CGM responses to duplicate meals in an inpatient setting.MethodsCGM data were collected in two controlled feeding studies (NCT03407053 and NCT03878108) in 30 participants without diabetes capturing 948 meal responses in duplicate ~1 week apart from three dietary patterns. One study used two different CGMs (Abbott Freestyle Libre Pro and Dexcom G4 Platinum) whereas the other study used only Dexcom. We calculated the incremental area under the curve (iAUC) for each 2-h post-meal period and compared within-subject iAUCs using the same CGM for the duplicate meals using linear correlations, intra-class correlation coefficients (ICC), Bland-Altman analyses, and compared individual variability of glycemic responses to duplicate meals versus different meals using standard deviations (SDs).ResultsThere were weak to moderate positive linear correlations between within-subject iAUCs for duplicate meals (Abbott r=0.47, p<0.0001, Dexcom r=0.40, p<0.0001), with low within-participant reliability indicated by ICC (Abbott 0.31, Dexcom 0.16). Bland-Altman analyses indicated wide limits of agreement (Abbott -31.4 to 31.5 mg/dL, Dexcom -32.3 to 31.6 mg/dL) but no significant bias of mean iAUCs for duplicate meals (Abbott 0.1 mg/dL, Dexcom -0.3 mg/dL). Individual variability of glycemic responses to duplicate meals was similar to that of different meals evaluated each diet week for both Abbott (SDduplicate = 10.7 mg/dL, SDweek 1 =12.4 mg/dL, SDweek 2 =11.6 mg/dL, p=0.38) and Dexcom (SDduplicate = 11.8 mg/dL, SDweek 1 =12.2 mg/dL, SDweek 2 =12.4 mg/dL, p=0.80).ConclusionsIndividual postprandial CGM responses to duplicate meals were unreliable in adults without diabetes. Personalized diet advice based on CGM measurements in adults without diabetes requires more reliable methods involving aggregated repeated measurements.

Project description:BackgroundIt remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caudad cutaneous effects compared with a basal-only infusion.MethodsBilateral TAP catheters (posterior approach) were inserted in 24 healthy volunteers followed by ropivacaine 2 mg/mL administration for a total of 6 hours. The right side was randomly assigned to either a basal infusion (8 mL/h) or bolus doses (24 mL administered every 3 hours for a total of 2 bolus doses) in a double-masked manner. The left side received the alternate treatment. The primary end point was the extent of sensory deficit as measured by cool roller along the axillary line at hour 6 (6 hours after the local anesthetic administration was initiated). Secondary end points included the extent of sensory deficit as measured by cool roller and Von Frey filaments along the axillary line and along a transverse line at the level of the anterior superior iliac spine at hours 0 to 6.ResultsAlthough there were statistically significant differences between treatments within the earlier part of the administration period, by hour 6 the difference in extent of sensory deficit to cold failed to reach statistical significance along the axillary line (mean = 0.9 cm; SD = 6.8; 95% confidence interval -2.0 to 3.8; P = .515) and transverse line (mean = 2.5 cm; SD = 10.1; 95% confidence interval -1.8 to 6.8; P = .244). Although the difference between treatments was statistically significant at various early time points for the horizontal, vertical, and estimated area measurements of both cold and mechanical pressure sensory deficits, no comparison remained statistically significant by hour 6.ConclusionsNo evidence was found in this study involving healthy volunteers to support the hypothesis that changing the local anesthetic administration technique (continuous basal versus hourly bolus) when using ropivacaine 0.2% and TAP catheters at 8 mL/h and 24 mL every 3 hours significantly influences the cutaneous effects after 6 hours of administration. Additional research is required to determine whether changing variables (eg, local anesthetic concentration, basal infusion rate, bolus dose volume, and/or interval) would provide different results.

Dataset Information

Effect of varying glycemic index meals on blood glucose control assessed with continuous glucose monitoring in youth with type 1 diabetes on basal-bolus insulin regimens.

Publications

Effect of varying glycemic index meals on blood glucose control assessed with continuous glucose monitoring in youth with type 1 diabetes on basal-bolus insulin regimens.

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