Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-211 Gdansk, Poland.
Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland.
Nutrients. 2022 Nov 5;14(21):4689. doi: 10.3390/nu14214689.
Therapy for type 1 diabetes (T1DM) focuses on maintaining optimal blood glucose levels, achieved with intensive insulin treatment, proper nutrition, and physical activity. The aim of this study was to investigate postprandial glycemic changes under low (30%) and standard (50%) carbohydrate diets in adolescents with T1DM. A single-center cross-over nutritional study was conducted, during which 26 adolescent patients provided 220 continuous glucose-monitored (CGM) meals data from the two consecutive 3-day nutritional plans. Overall, the 50% carbohydrate diet was associated with higher postprandial glucose variability in the small meals (afternoon snacks, second breakfast) and greater postprandial peaks for other meals (breakfast, dinner, supper). Nevertheless, after the adjustment of a patient's individual clinical variables (age, Tanner classification, glucose disposal rate), we observed that mean postprandial glucose was higher for afternoon snacks and lower for suppers in the 30% carbohydrate diet. Although a 30% carbohydrate diet seems to offer better postprandial glycemia, it requires additional attention from the physician and patient when it comes to modifying daily carbohydrate intake. Increased fat/protein content and size of the main meal lead to a prolonged postprandial glycemic response, which may affect the insulin treatment and result in suboptimal glycemic control.
1 型糖尿病（T1DM）的治疗重点是通过强化胰岛素治疗、适当的营养和体育活动来维持最佳血糖水平。本研究旨在调查青少年 T1DM 患者在低碳水化合物（30%）和标准碳水化合物（50%）饮食下的餐后血糖变化。进行了一项单中心交叉营养研究，在此期间，26 名青少年患者提供了 220 个连续血糖监测（CGM）餐的数据，来自两个连续 3 天的营养计划。总体而言，50%碳水化合物饮食与小餐（下午零食、第二早餐）的餐后血糖变异性更高，其他餐（早餐、晚餐、夜宵）的餐后峰值更大。然而，在调整了患者的个体临床变量（年龄、Tanner 分类、葡萄糖处置率）后，我们观察到 30%碳水化合物饮食的下午零食餐后血糖更高，夜宵餐后血糖更低。尽管 30%碳水化合物饮食似乎可以提供更好的餐后血糖，但在调整日常碳水化合物摄入量时，需要医生和患者给予更多关注。增加脂肪/蛋白质含量和主餐的份量会导致餐后血糖反应延长，这可能会影响胰岛素治疗并导致血糖控制不佳。
