Insulin Dose Adjustments for Meals Differing in Fat Content in T1DM
Status:
Completed
Trial end date:
2015-07-01
Target enrollment:
Participant gender:
Summary
People with Type 1 diabetes (T1DM) are usually provided guidance on how best to control
glycaemia around meal times through adjusting their rapid-acting insulin dose according to
the carbohydrate content of the meal (e.g. 1 IU per 10/15 g of carbohydrate; Schmidt et al.,
2014). However, a potential issue around this method is the role of dietary fat in the
calculation of insulin requirements (Wolpert et al., 2013). The fat component of the meal has
the potential to influence the insulin dose requirement to normalise postprandial glycaemia
(Wolpert et al., 2013). Although normalising postprandial glycaemia is vital, postprandial
lipaemia is also an important consideration for long-term health, and at present there is
scant data in this area in T1DM. In addition, changing the macronutrient composition of foods
and altering insulin doses may carry important implications for vascular function and
prospective appetite regulation.
This research will examine the glycaemic and lipaemic responses after consuming a mixed meal
similar in carbohydrate content, but differing in fat content. Moreover, this research will
assess whether acute postprandial reductions in insulin sensitivity can be offset through
increasing the dose of rapid-acting insulin for such meals. Venous blood samples will be
collected before and for 6 hours after meals, for the determination of glycaemic and lipaemic
responses, as well as metabolite and hormonal parameters. In addition this study will assess
the impact of mixed meals and adjusting insulin dose on vascular function and subjective
ratings of appetite.
The findings from this study will benefit patients with type 1 diabetes by the provision of
more refined self-management strategies for insulin dosage around meal-times.