Benefit of supplementary fat plus protein counting as compared with conventional carbohydrate counting for insulin bolus calculation in children with pump therapy.

Abstract:

OBJECTIVE:To investigate carbohydrate (CARB) and supplementary fat/protein (CFP) counting using normal and dual-wave bolus in pump therapy of children and young people with type 1 diabetes (T1D). STUDY DESIGN AND METHODS:A randomized clinical trial was conducted in 42 patients (age 6-21 yr) with T1D for at least 1 yr (5.2 ± 3.1 yr, mean ± SD) and pump therapy for at least 3 months (3.3 ± 1.8 yr). Standardized test meals (pizza-salami; 50% carbohydrate, 34% fat, 16% protein; corresponding to 33% of age-adjusted daily energy requirement) were given at lunch time on four different days with normal and dual-wave bolus using CARB and CFP counting in a randomized sequence. Sensor-augmented pumps were used for continuous glucose monitoring of 6-h postprandial glucose profiles. Intra-individual comparisons of glucose parameters [area under the curve (AUC) mg/dL × 6 h; average glucose, AV mg/dL] were performed. RESULTS:Using CFP counting, 6-h postprandial glucose AUC (805 ± 261) and AV (137.8 ± 46.2) were significantly lower than AUC (926 ± 285) and AV (160.5 ± 51.9) by CARB counting (p < 0.001, each). CFP counting led to significantly lower postprandial glucose parameters independently from the kind of bolus (normal bolus: ΔAUC 169, p < 0.001; ΔAV 30.6, p < 0.001/dual-wave bolus: ΔAUC 73, p = 0.045, ΔAV 14.8, p = 0.033). Postprandial hypoglycemia episodes (<70 mg/dL) occurred more frequently in CFP than in CARB counting (35.7% vs. 9.5%, p < 0.001). No severe hypoglycemia was reported. CONCLUSION:In patients with long-term T1D, meal-related insulin dosing based on carbohydrate plus fat/protein counting reduces the postprandial glucose levels (ClinicalTrials.gov NCT01400659).

journal_name

Pediatr Diabetes

journal_title

Pediatric diabetes

authors

Kordonouri O,Hartmann R,Remus K,Bläsig S,Sadeghian E,Danne T

doi

10.1111/j.1399-5448.2012.00880.x

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

540-4

issue

7

eissn

1399-543X

issn

1399-5448

journal_volume

13

pub_type

杂志文章,随机对照试验
  • The IDF Life for a Child Program Index of diabetes care for children and youth.

    abstract:BACKGROUND AND OBJECTIVES:Care for children and youth with diabetes varies markedly around the world. We developed a standardized, reproducible measure that can be used to document and compare critical factors influencing treatment outcomes. METHODS:A questionnaire consisting of 36 multiple-choice questions covering m...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12296

    authors: Ogle GD,Middlehurst AC,Silink M

    更新日期:2016-08-01 00:00:00

  • Identity and treatment adherence in predominantly ethnic minority teens and young adults with type 1 diabetes.

    abstract:BACKGROUND:The demands of diabetes care can place substantial burden on youth with type 1 diabetes (T1D), who must manage their treatment in conjunction with the developmentally typical tasks of adolescence. How diabetes affects the normative task of identity development deserves further exploration. METHODS:A sample ...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12932

    authors: Commissariat PV,Laffel LM,Gonzalez JS

    更新日期:2020-02-01 00:00:00

  • Neuropeptide Y is a minor autoantigen in newly diagnosed type 1 diabetes patients.

    abstract:BACKGROUND:Autoantibodies (A) against Neuropeptide Y (NPY), was reported in 9% newly diagnosed type 1 diabetes (T1D) patients. A single nucleotide polymorphism (SNP) at rs16139 (T1128C) within the NPY-gene identified an amino acid substitution from leucine (L) to proline (P) (L7P) associated with both glucose tolerance...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12222

    authors: Skärstrand H,Vaziri-Sani F,Delli AJ,Törn C,Elding Larsson H,Ivarsson S,Agardh D,Lernmark Å,Skåne study group.

    更新日期:2015-12-01 00:00:00

  • Participant and parent experiences in the oral insulin study of the Diabetes Prevention Trial for Type 1 Diabetes.

    abstract:OBJECTIVE:To assess the experiences of participants and parents of children in the oral insulin study of the Diabetes Prevention Trial - Type 1. METHOD:Before trial results were publicized, surveys were completed by 124 participants and 219 parents of children in the oral trial. RESULTS:Although most of those surveye...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1399-5448.2008.00463.x

    authors: Johnson SB,Baughcum AE,Rafkin-Mervis LE,Schatz DA,DPT-1 Study Group.

    更新日期:2009-05-01 00:00:00

  • Renal Doppler indices in diabetic children with insulin resistance syndrome.

    abstract::End-stage renal failure is still a leading cause of mortality among type 1 diabetes patients. Insulin resistance plays a larger role in type 1 diabetes disease process than is commonly recognized. Detection of diabetic nephropathy as early as possible currently offers the best chance of delaying or possibly preventing...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2009.00628.x

    authors: Abd El Ghaffar S,El Kaffas K,Hegazy R,Mostafa M

    更新日期:2010-11-01 00:00:00

  • Partial ABCC8 gene deletion mutations causing diazoxide-unresponsive hyperinsulinaemic hypoglycaemia.

    abstract::Inactivating mutations in the pancreatic beta cell ATP-sensitive potassium (K(ATP) ) channel genes are identified by sequencing in approximately 80% of patients with diazoxide-unresponsive hyperinsulinaemic hypoglycaemia (HH). Genetic testing is clinically important as the mode of inheritance of a K(ATP) channel mutat...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2011.00821.x

    authors: Flanagan S,Damhuis A,Banerjee I,Rokicki D,Jefferies C,Kapoor R,Hussain K,Ellard S

    更新日期:2012-05-01 00:00:00

  • Inflammatory cytokine, growth factor and counterregulatory responses to exercise in children with type 1 diabetes and healthy controls.

    abstract::In children with type 1 diabetes (T1DM), altered adaptive responses to exercise (secretion of growth factors, inflammatory cytokines, and glucoregulatory mediators) may have potential implications in growth and development, early onset of disease complications, and incidence of hypoglycemia. We therefore measured a br...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-543X.2006.00140.x

    authors: Galassetti PR,Iwanaga K,Crisostomo M,Zaldivar FP,Larson J,Pescatello A

    更新日期:2006-02-01 00:00:00

  • Aerobic exercise capacity in normal adolescents and those with type 1 diabetes mellitus.

    abstract:OBJECTIVE:To compare the aerobic exercise capacity between normal adolescents and those with type 1 diabetes mellitus (T1DM). METHODS:An experimental group with 72 individuals diagnosed with T1DM aged 9--20, time from diagnosis 4.9 +/- 3.6 yr, without clinical cardiopulmonary disease or anemia and a control group (C) ...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-543X.2005.00120.x

    authors: Komatsu WR,Gabbay MA,Castro ML,Saraiva GL,Chacra AR,de Barros Neto TL,Dib SA

    更新日期:2005-09-01 00:00:00

  • Plasma insulin levels in childhood are related to maternal factors--results of the Ulm Birth Cohort Study.

    abstract:AIMS:The cardiovascular risk factor profile of a child as well as the development of body weight are influenced by genetic and childhood factors. Circulating insulin concentrations reflect the metabolic cardiovascular risk and may trigger weight gain. We aimed at identifying parental and childhood factors which may inf...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12109

    authors: Brandt S,Moß A,Lennerz B,Koenig W,Weyermann M,Rothenbacher D,Brenner H,Wabitsch M

    更新日期:2014-09-01 00:00:00

  • Changes to Care Delivery at Nine International Pediatric Diabetes Clinics in Response to the COVID-19 Global Pandemic.

    abstract:BACKGROUND:Pediatric diabetes clinics around the world rapidly adapted care in response to COVID-19. We explored provider perceptions of care delivery adaptations and challenges for providers and patients across nine international pediatric diabetes clinics. METHODS:Providers in a quality improvement collaborative com...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.13180

    authors: Cristello Sarteau A,Souris KJ,Wang J,Ramadan AA,Addala A,Bowlby D,Corathers S,Forsander G,King B,Law JR,Liu W,Malik F,Pihoker C,Seid M,Smart C,Sundberg F,Tandon N,Yao M,Headley T,Mayer-Davis E

    更新日期:2021-01-19 00:00:00

  • Influence of initial insulin dosage on blood glucose dynamics of children and adolescents with newly diagnosed type 1 diabetes mellitus.

    abstract:OBJECTIVE:To investigate the effect of initial insulin dosage on blood glucose (BG) dynamics, β-cell protection, and oxidative stress in type 1 diabetes mellitus. METHODS:Sixty newly diagnosed type 1 diabetes mellitus patients were randomly assigned to continuous subcutaneous insulin infusions of 0.6 ± 0.2 IU/kg/d (gr...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/pedi.12374

    authors: Wang Y,Gong C,Cao B,Meng X,Wei L,Wu D,Liang X,Li W,Liu M,Gu Y,Su C

    更新日期:2017-05-01 00:00:00

  • A 10-yr follow-up study for the detection of peripheral neuropathy in young patients with type 1 diabetes.

    abstract:OBJECTIVE:The main objective of this work was to follow-up the development of diabetic neuropathy (DN) and its severity in patients with type 1 diabetes over 10 yr. Our intention was also to observe risk factor changes and verify which of them influence the development of neuropathy. The other objective was longitudina...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12382

    authors: Hajas G,Kissova V,Tirpakova A

    更新日期:2016-12-01 00:00:00

  • Clinical picture of childhood type 1 diabetes mellitus in the Eastern Province of Saudi Arabia.

    abstract:AIM:Study of the clinical presentation and laboratory data of type 1 diabetes in the Eastern Province of Saudi Arabia. METHODS:The medical records of all affected children during the period 1986-1997 were reviewed for the analysis of clinical and laboratory data. RESULTS:Type 1 diabetes was diagnosed in 46 children, ...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1046/j.1399-543x.2001.00000.x

    authors: Kulaylat NA,Narchi H

    更新日期:2001-03-01 00:00:00

  • Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS).

    abstract:BACKGROUND AND OBJECTIVE:There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definit...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12349

    authors: Asghari G,Eftekharzadeh A,Hosseinpanah F,Ghareh S,Mirmiran P,Azizi F

    更新日期:2017-02-01 00:00:00

  • Cardiac structure and function in youth with type 2 diabetes in the iCARE cohort study: Cross-sectional associations with prenatal exposure to diabetes and metabolomic profiles.

    abstract:OBJECTIVE:This study aimed to determine the degree of left ventricular (LV) dysfunction and its determinants in adolescents with type 2 diabetes (T2D). We hypothesized that adolescents with T2D would display impaired LV diastolic function and that these cardiovascular complications would be exacerbated in youth exposed...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12954

    authors: Guillemette L,Dart A,Wicklow B,Dolinsky VW,Cheung D,Jassal DS,Sellers EAC,Gelinas J,Eves ND,Balshaw R,Agarwal P,Duhamel TA,Gordon JW,McGavock JM

    更新日期:2020-03-01 00:00:00

  • Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes.

    abstract:OBJECTIVES:To assess the ability of reactive hyperemia-peripheral artery tonometry (RH-PAT) to serve as a surrogate marker of endothelial dysfunction in children with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS:Forty-four children with T1D [age 14.6 +/- 2.7 yr; duration of diabetes 6.01 +/- 4 yr; range of diabe...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2007.00246.x

    authors: Haller MJ,Stein J,Shuster J,Theriaque D,Silverstein J,Schatz DA,Earing MG,Lerman A,Mahmud FH

    更新日期:2007-08-01 00:00:00

  • Comprehensive assessment of postischemic vascular reactivity in Hispanic children and adults with and without diabetes mellitus.

    abstract:BACKGROUND:To examine the whole postischemic hyperemic response period in Hispanic children and adults with and without type 2 diabetes mellitus (T2DM) and offer insight into the potential adaptive mechanisms involved in the arterial response to disturbances in vascular homeostasis. METHODS:Ninety-eight adults and 124...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2006.00209.x

    authors: Wajcberg E,Thoppil N,Patel S,Fernandez M,Hale D,DeFronzo R,Cersosimo E

    更新日期:2006-12-01 00:00:00

  • The pancreatic ductal epithelium serves as a potential pool of progenitor cells.

    abstract::With the increasing success of islet transplantation, beta-cell replacement therapy has had renewed interest. To make such a therapy available to more than a few of the thousands of patients with diabetes, new sources of insulin-producing cells must become readily available. The most promising sources are stem cells, ...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章,评审

    doi:10.1111/j.1399-543X.2004.00075.x

    authors: Bonner-Weir S,Toschi E,Inada A,Reitz P,Fonseca SY,Aye T,Sharma A

    更新日期:2004-01-01 00:00:00

  • Outpatient transition of an infant with permanent neonatal diabetes due to a KCNJ11 activating mutation from subcutaneous insulin to oral glyburide.

    abstract::Neonatal diabetes mellitus is rare, may either be transient or permanent, and may be caused by mutations in any of the several different genes. Until recently, most forms of permanent neonatal diabetes required lifelong subcutaneous insulin for management; however, permanent neonatal diabetes due to activating mutatio...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2007.00316.x

    authors: Bremer AA,Ranadive S,Lustig RH

    更新日期:2008-06-01 00:00:00

  • Detection and treatment efficacy of hypoglycemic events in the everyday life of children younger than 7 yr.

    abstract:BACKGROUND:Mild hypoglycemia is commonly observed in children treated for type 1 diabetes mellitus (T1DM). Hypoglycemia disturbs cognition and learning. OBJECTIVE:To describe how and to what extent hypoglycemia in young children with T1DM is detected in everyday life. To learn how parents and caregivers treat hypoglyc...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12057

    authors: Sundberg F,Forsander G

    更新日期:2014-02-01 00:00:00

  • Immune cell and cytokine patterns in children with type 1 diabetes mellitus undergoing a remission phase: A longitudinal study.

    abstract:OBJECTIVE:Type 1 diabetes (T1D) develops in distinct stages, before and after disease onset. Whether the natural course translates into different immunologic patterns is still uncertain. This study aimed at identifying peripheral immune patterns at key time-points, in T1D children undergoing remission phase. METHODS:C...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12671

    authors: Fitas AL,Martins C,Borrego LM,Lopes L,Jörns A,Lenzen S,Limbert C

    更新日期:2018-08-01 00:00:00

  • The Environmental Determinants of Diabetes in the Young (TEDDY) study: predictors of early study withdrawal among participants with no family history of type 1 diabetes.

    abstract:OBJECTIVE:The Environmental Determinants of Diabetes in the Young (TEDDY) study seeks to identify environmental triggers of autoimmunity and type 1 diabetes mellitus (T1DM) in children at increased human-leukocyte-antigen conferred genetic risk for this disease. The objective of this study was to identify predictors of...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2010.00686.x

    authors: Johnson SB,Lee HS,Baxter J,Lernmark B,Roth R,Simell T,TEDDY Study Group.

    更新日期:2011-05-01 00:00:00

  • Monogenic diabetes: A single center experience from South India.

    abstract::Monogenic forms of diabetes in children are frequently misclassified as either type 1 diabetes or young-onset type 2 diabetes. There is a paucity of literature regarding pediatric monogenic diabetes in the Indian population. A retrospective analysis of case records of 37 children with monogenic diabetes who were diagn...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.13040

    authors: Lakshmanan NK,Pavithran PV,Bhavani N,Abraham N,Kumar H,Nair V,Menon U,Menon AS,Narayanan P,Lakshmi G

    更新日期:2021-02-01 00:00:00

  • Type 1 diabetes and epilepsy in childhood and adolescence: Do glutamic acid decarboxylase autoantibodies play a role? Data from the German/Austrian/Swiss/Luxembourgian DPV Registry.

    abstract:AIMS:We aimed to analyze the relationship between epilepsy and glutamic acid decarboxylase autoantibodies (GADA) in patients with type 1 diabetes mellitus (T1DM) and the impact of GADA on demographic, clinical, and metabolic data in T1DM patients with epilepsy. METHODS:We searched for patients with T1DM ≤20 years and ...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.13034

    authors: de Sousa GJ,Tittel SR,Häusler M,Holterhus PM,Berger G,Holder M,Kamrath C,Golembowski S,Herrlinger S,Holl RW

    更新日期:2020-08-01 00:00:00

  • Intramyocellular lipid, adiposity, and muscle oxygen supply in prepubertal type 1 diabetes.

    abstract:BACKGROUND:In the non-diabetic population, intramyocellular lipid (IMCL) accumulation is associated with obesity and poor muscle oxygen supply. IMCL levels are increased in type 1 diabetes, but their significance is less clear. METHODS:We studied a group of 16 prepubertal boys (age 6.4-9.9 yr) with type 1 diabetes and...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1034/j.1399-5448.2003.00021.x

    authors: Ling AH,Donaghue KC,Howard NJ,Arrowsmith FE,Ward JA,Baur LA,Thompson CH

    更新日期:2003-09-01 00:00:00

  • HbA1c but not diabetes duration predicts increased arterial stiffness in adolescents with poorly controlled type 1 diabetes.

    abstract:BACKGROUND:The prevalence of macrovascular complications is probably underestimated in children with type 1 diabetes (T1D). Arterial stiffness (AS) is a subclinical marker of cardiovascular (CV) risk. The most validated, non-invasive method for AS measurement is pulse wave velocity (PWV). Only a few PWV studies have be...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12385

    authors: Obermannova B,Petruzelkova L,Sulakova T,Sumnik Z

    更新日期:2017-06-01 00:00:00

  • Alterations in left ventricular, left atrial, and right ventricular structure and function to cardiovascular risk factors in adolescents with type 2 diabetes participating in the TODAY clinical trial.

    abstract::Data on cardiovascular disease (CVD) risk in adolescents with type 2 diabetes (T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial (median 4½ yr from diagnosis of T2D, average age 18 yr), including MMode and 2D m...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/pedi.12119

    authors: Levitt Katz L,Gidding SS,Bacha F,Hirst K,McKay S,Pyle L,Lima JA,TODAY Study Group.

    更新日期:2015-02-01 00:00:00

  • Increase in the incidence of type 1 diabetes in Israeli children following the Second Lebanon War.

    abstract:BACKGROUND:Type 1 diabetes is an autoimmune disease occurring in genetically susceptible individuals. The precipitating cause is unclear. Recently, the Second Lebanon War exposed a large civilian population in northern Israel to significant psychological stress in the form of repeated barrages of missile attacks. HYPO...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/j.1399-5448.2011.00838.x

    authors: Zung A,Blumenfeld O,Shehadeh N,Dally Gottfried O,Tenenbaum Rakover Y,Hershkovitz E,Gillis D,Zangen D,Pinhas-Hamiel O,Hanukoglu A,Rachmiel M,Shalitin S,Israel IDDM Registry Study Group.

    更新日期:2012-06-01 00:00:00

  • A multivariate model exploring the predictive value of demographic, adolescent, and family factors on glycemic control in adolescents with type 1 diabetes.

    abstract:OBJECTIVE:The current study examined how a comprehensive set of variables from multiple domains, including at the adolescent and family level, were predictive of glycemic control in adolescents with type 1 diabetes (T1D). METHODS:Participants included 100 adolescents with T1D ages 10-16 yrs and their parents. Particip...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12331

    authors: Agarwal S,Jawad AF,Miller VA

    更新日期:2016-11-01 00:00:00

  • Partial remission in Brazilian children and adolescents with type 1 diabetes. Association with a haplotype of class II human leukocyte antigen and synthesis of autoantibodies.

    abstract:OBJECTIVE:Characterization of partial remission using the insulin dose-adjusted HbA1c (IDAA1c) ≤ 9 definition in a multiethnic Brazilian population of children and adolescents with type 1 diabetes (T1D), in addition with the determination of both Class II HLA genotype and autoantibodies. METHODS:We analyzed the preval...

    journal_title:Pediatric diabetes

    pub_type: 杂志文章

    doi:10.1111/pedi.12999

    authors: Camilo DS,Pradella F,Paulino MF,Baracat ECE,Marini SH,Guerra G Jr,Pavin EJ,Parisi C,Longhini ALF,Marques SB,Guariento EG,Lieber SR,Macedo CF,Gama E Silva L,Farias AS,Santos LMB,Volpini WMG

    更新日期:2020-06-01 00:00:00