Haase, Maike;
Kahle, Melanie;
Janert, Martin;
Meier, Juris J.;
Nauck, Michael A.
Basal rate tests (24‐hour fasts) performed in type‐1 diabetic subjects with either absolute fasting or snacks containing negligible carbohydrate amounts result in similar glucose profiles: A randomized controlled prospective trial
You can manage bookmarks using lists, please log in to your user account for this.
Media type:
E-Article
Title:
Basal rate tests (24‐hour fasts) performed in type‐1 diabetic subjects with either absolute fasting or snacks containing negligible carbohydrate amounts result in similar glucose profiles: A randomized controlled prospective trial
Contributor:
Haase, Maike;
Kahle, Melanie;
Janert, Martin;
Meier, Juris J.;
Nauck, Michael A.
Published:
Wiley, 2017
Published in:
Diabetes, Obesity and Metabolism, 19 (2017) 6, Seite 783-790
Description:
<jats:sec><jats:title>Aims</jats:title><jats:p>Basal rate tests (24‐hour fasting periods) may be necessary to optimize basal insulin replacement in type 1 diabetes. It was the aim of this study to prospectively compare the allowance of negligible carbohydrate snacks vs absolute fasting.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A total of 20 patients with type 1 diabetes (age, 48 ± 15 years (9 women, 11 men); <jats:styled-content style="fixed-case">BMI</jats:styled-content>, 28.5 ± 4.5 kg/m<jats:sup>2</jats:sup>; <jats:styled-content style="fixed-case">HbA1c</jats:styled-content>, 8.8% ± 2.0% (73.0 ± 21.9 mmol/mol); insulin dose, 0.69 ± 0.31 <jats:styled-content style="fixed-case">IU</jats:styled-content>/kg body weight and per day) participated in 2 basal rate tests lasting 24 hours in random order with unchanged basal insulin replacement. On 1 occasion, negligible carbohydrate snacks (salads and vegetables, up to 5.1 g carbohydrate and 276.3 <jats:styled-content style="fixed-case">kJ</jats:styled-content> per portion) were allowed; during the second test subjects were obliged to fast absolutely. Plasma glucose profiles were determined using an exact laboratory method. Hypoglycaemic episodes (plasma glucose < 70 mg/d<jats:styled-content style="fixed-case">L</jats:styled-content>) were compared.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Plasma glucose concentrations during fasting periods, with and without negligible carbohydrate snacks, did not differ significantly (<jats:italic>
<jats:styled-content style="fixed-case">P</jats:styled-content></jats:italic> = .65) and differences were negligible (95% confidence intervals always included a difference of 0 mmol/<jats:styled-content style="fixed-case">L</jats:styled-content>). Also, there was no difference in the number of hypoglycaemic plasma glucose values (<jats:italic><jats:styled-content style="fixed-case">P</jats:styled-content></jats:italic> = .40) or in compensatory carbohydrate intake. Basal rate testing with negligible carbohydrate snacks was better tolerated (questionnaire, <jats:italic><jats:styled-content style="fixed-case">P</jats:styled-content></jats:italic> = .046) and the desire to discontinue the fasting period was significantly reduced (<jats:italic><jats:styled-content style="fixed-case">P</jats:styled-content></jats:italic> = .023).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Allowing negligible carbohydrate snacks results in unchanged plasma glucose profiles during basal rate testing and is better tolerated by patients with type 1 diabetes.</jats:p></jats:sec>