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University of Newcastle, Australia

In children and young people with type 1 diabetes using Pump therapy, an additional 40% of the insulin dose for a high‐fat, high‐protein breakfast improves postprandial glycaemic excursions: A cross‐ov…

Overview of attention for article published in Diabetic Medicine, February 2021
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Title
In children and young people with type 1 diabetes using Pump therapy, an additional 40% of the insulin dose for a high‐fat, high‐protein breakfast improves postprandial glycaemic excursions: A cross‐over trial
Published in
Diabetic Medicine, February 2021
DOI 10.1111/dme.14511
Pubmed ID
Authors

Tenele A. Smith, Carmel E. Smart, Michelle E. J. Fuery, Peter P. Howley, Brigid A. Knight, Mark Harris, Bruce R. King

Abstract

To determine the insulin requirement for a high fat, high protein breakfast to optimise postprandial glycaemic excursions in children and young people with type 1 diabetes using insulin pumps. Twenty-seven participants age 10-23 years, BMI <95th percentile (2-18 years) or BMI <30 kg/m2 (19-25 years) and HbA1c ≤64 mmol/mol (≤8.0%) consumed a high fat, high protein breakfast (carbohydrate:30g, fat:40g, protein:50g) on four days. In this cross-over trial insulin was administered, based on the insulin-to-carbohydrate ratio (ICR) of 100% (control), 120%, 140% and 160%, in an order defined by a randomisation sequence and delivered in a combination bolus, 60% ¼ hr pre-meal and 40% over 3 hr. Postprandial sensor glucose was assessed for 6 hr. Compared to 100%ICR, 140%ICR and 160%ICR resulted in significantly lower 6 hr areas under the glucose curves: mean (95%CI) (822 mmol/L.min [605,1039] and 567 [350,784] vs 1249 [1042,1457],p≤0.001) and peak glucose excursions (4.0 mmol/L [3.0,4.9] and 2.7 [1.7,3.6] vs 6.0 [5.0,6.9],p<0.001). Rates of hypoglycaemia for 100%-160%ICR were 7.7%, 7.7%, 12% and 19% respectively (p≥0.139). With increasing insulin dose, a step-wise reduction in mean glucose excursion was observed from 1-6 hr (p=0.008). Incrementally increasing the insulin dose for a high fat, high protein breakfast resulted in a predictable, dose-dependent reduction in postprandial glycaemia: 140%ICR improved postprandial glycaemic excursions without a statistically significant increase in hypoglycaemia. These findings support a safe, practical method for insulin adjustment for high fat, high protein meals that can be readily implemented in practice to improve postprandial glycaemia.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 44 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 5 11%
Researcher 3 7%
Student > Bachelor 3 7%
Student > Doctoral Student 2 5%
Unspecified 2 5%
Other 8 18%
Unknown 21 48%
Readers by discipline Count As %
Medicine and Dentistry 7 16%
Nursing and Health Professions 6 14%
Psychology 3 7%
Unspecified 2 5%
Philosophy 1 2%
Other 3 7%
Unknown 22 50%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 January 2021.
All research outputs
#20,676,689
of 23,271,751 outputs
Outputs from Diabetic Medicine
#3,468
of 3,613 outputs
Outputs of similar age
#433,477
of 506,279 outputs
Outputs of similar age from Diabetic Medicine
#42
of 45 outputs
Altmetric has tracked 23,271,751 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
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