Paterson Megan, Bell Kirstine J, O'Connell Susan M, Smart Carmel E, Shafat Amir, King Bruce
Department of Paediatric Diabetes and Endocrinology, John Hunter Children's Hospital, Newcastle, NSW, Australia,
Curr Diab Rep. 2015 Sep;15(9):61. doi: 10.1007/s11892-015-0630-5.
A primary focus of the management of type 1 diabetes has been on matching prandial insulin therapy with carbohydrate amount consumed. However, even with the introduction of more flexible intensive insulin regimes, people with type 1 diabetes still struggle to achieve optimal glycaemic control. More recently, dietary fat and protein have been recognised as having a significant impact on postprandial blood glucose levels. Fat and protein independently increase the postprandial glucose excursions and together their effect is additive. This article reviews how the fat and protein in a meal impact the postprandial glycaemic response and discusses practical approaches to managing this in clinical practice. These insights have significant implications for patient education, mealtime insulin dose calculations and dosing strategies.
1型糖尿病管理的一个主要重点一直是使餐时胰岛素治疗与所摄入的碳水化合物量相匹配。然而,即使引入了更灵活的强化胰岛素治疗方案,1型糖尿病患者仍难以实现最佳血糖控制。最近,膳食脂肪和蛋白质已被认为对餐后血糖水平有重大影响。脂肪和蛋白质各自独立增加餐后血糖波动,并且它们的作用是相加的。本文综述了一餐中的脂肪和蛋白质如何影响餐后血糖反应,并讨论了在临床实践中对此进行管理的实用方法。这些见解对患者教育、进餐时胰岛素剂量计算和给药策略具有重要意义。