Centre for Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia.
Int J Clin Pract. 2009 Feb;63(2):189-94. doi: 10.1111/j.1742-1241.2008.01970.x.
Intensive insulin therapy (IIT) is the preferred treatment for patients with type 1 diabetes, which requires them to calculate the total number of grams of carbohydrate eaten, but little research has been performed on the effect of mixed meals on blood sugar. We examined the effects of popular takeaway foods on glycaemic response in people with type 1 diabetes.
Nine participants on IIT each consumed a pasta, Thai, hamburger and sandwich (cheese sandwich and an apple) meal on four different occasions, at least 3 days apart. The meals had the same amount of carbohydrate but different macronutrient quantities and different glycaemic indices (GI). Participants' normal basal insulin was given, but the mealtime bolus insulin was withheld to measure blood glucose level (BGL), every half hour for 3 h postprandially.
The glycaemic response as measured by 2-h BGL, the area under the BGL curve and BGL range (maximum-minimum over 3 h) were consistently lower after ingesting a low-GI high-fat pasta meal in relation to the other meals. There was no difference between the sandwich, Thai and hamburger meals. BGLs rose between 3.91 and 8.44 mmol/l at the conclusion of 3 h, which shows that a single CHO portion (15 g) can raise BGLs by 1-2 mmol/l, depending on the GI of the food.
People with type 1 diabetes on IIT who are concerned about postprandial glycaemic variability should consider not only overall carbohydrate content but also glycaemic index and fat content when adjusting insulin dosages.
强化胰岛素治疗(IIT)是 1 型糖尿病患者的首选治疗方法,需要他们计算所吃碳水化合物的总克数,但关于混合餐对血糖的影响的研究较少。我们研究了常见外卖食品对 1 型糖尿病患者血糖反应的影响。
9 名接受 IIT 的参与者在 4 个不同的时间点(至少相隔 3 天)分别食用了意大利面、泰式、汉堡和三明治(奶酪三明治和一个苹果)餐,这些餐的碳水化合物含量相同,但宏量营养素的数量和血糖指数(GI)不同。参与者给予正常的基础胰岛素,但为了测量餐后 3 小时的血糖水平(BGL),不给予进餐时的胰岛素推注。
与其他餐相比,进食低 GI 高脂肪的意面餐后,2 小时 BGL、BGL 曲线下面积和 BGL 范围(3 小时内的最大-最小)的血糖反应一直较低。三明治、泰式和汉堡餐之间没有差异。3 小时结束时,BGL 升高了 3.91 至 8.44mmol/l,这表明根据食物的 GI,单个 CHO 份量(15g)可以使 BGL 升高 1-2mmol/l。
对于接受 IIT 的 1 型糖尿病患者,如果担心餐后血糖变异性,在调整胰岛素剂量时,不仅应考虑总碳水化合物含量,还应考虑血糖指数和脂肪含量。