The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial.

IF 3.9 2区 医学 Q2 NUTRITION & DIETETICS
Yunying Cai, Mengge Li, Lun Zhang, Jie Zhang, Heng Su
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Abstract

Background: The optimization of glucose control in type-1 diabetes is challenged by postprandial glycemic variability. This study aimed to compare the postprandial glycemic effects of carbohydrate counting and the modified fat-protein unit (FPU) algorithms following meals with different protein and fat emphases in adults with type-1 diabetes.

Methods: Thirty adults with type-1 diabetes aged 18 to 45 years participated in a randomized crossover trial. In a random order, participants consumed four test meals with equivalent energy and different macronutrient emphases on four separate mornings. The modified FPU algorithms and carbohydrate counting were used to determine the insulin dose for the test meals. A continuous glucose monitoring system was used to measured postprandial glycemia.

Results: Compared with carbohydrate counting, the modified FPU algorithm significantly decreased the late postprandial mean glucose levels (p = 0.026) in high protein-fat meals. The number of hypoglycemia episodes was similar between insulin dosing algorithms for the high protein-fat meals; hypoglycemic events were considerably higher for the modified FPU in the normal protein-fat meal (p = 0.042).

Conclusions: The modified FPU algorithm may improve postprandial glycemic control after consuming high protein-fat meals in adults with type-1 diabetes but may result in increased hypoglycemia risk when used with a normal protein-fat meal.

Abstract Image

1型糖尿病成年人在食用不同宏量营养成分的膳食时,改良脂肪-蛋白质单位算法与碳水化合物计数对餐后血糖的影响的比较:一项随机交叉试验。
背景:1型糖尿病血糖控制的优化受到餐后血糖变化的挑战。本研究旨在比较1型糖尿病成年人在不同蛋白质和脂肪重点饮食后碳水化合物计数和改良脂肪-蛋白质单位(FPU)算法对餐后血糖的影响。方法:30名18至45岁的1型糖尿病成年人参加了一项随机交叉试验。按照随机顺序,参与者在四个不同的早晨吃了四顿能量相等、重点不同的测试餐。使用改良的FPU算法和碳水化合物计数来确定测试膳食的胰岛素剂量。使用连续血糖监测系统来测量餐后血糖。结果:与碳水化合物计数相比,改进的FPU算法显著降低了餐后后期的平均血糖水平(p = 0.026)。高蛋白脂肪餐的胰岛素给药算法之间的低血糖发作次数相似;在正常蛋白质-脂肪膳食中,改良FPU的低血糖事件明显更高(p = 0.042)。结论:改良的FPU算法可以改善1型糖尿病成年人在食用高蛋白脂肪餐后的餐后血糖控制,但与正常蛋白脂肪餐一起使用可能会增加低血糖风险。
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来源期刊
Nutrition & Metabolism
Nutrition & Metabolism 医学-营养学
CiteScore
8.40
自引率
0.00%
发文量
78
审稿时长
4-8 weeks
期刊介绍: Nutrition & Metabolism publishes studies with a clear focus on nutrition and metabolism with applications ranging from nutrition needs, exercise physiology, clinical and population studies, as well as the underlying mechanisms in these aspects. The areas of interest for Nutrition & Metabolism encompass studies in molecular nutrition in the context of obesity, diabetes, lipedemias, metabolic syndrome and exercise physiology. Manuscripts related to molecular, cellular and human metabolism, nutrient sensing and nutrient–gene interactions are also in interest, as are submissions that have employed new and innovative strategies like metabolomics/lipidomics or other omic-based biomarkers to predict nutritional status and metabolic diseases. Key areas we wish to encourage submissions from include: -how diet and specific nutrients interact with genes, proteins or metabolites to influence metabolic phenotypes and disease outcomes; -the role of epigenetic factors and the microbiome in the pathogenesis of metabolic diseases and their influence on metabolic responses to diet and food components; -how diet and other environmental factors affect epigenetics and microbiota; the extent to which genetic and nongenetic factors modify personal metabolic responses to diet and food compositions and the mechanisms involved; -how specific biologic networks and nutrient sensing mechanisms attribute to metabolic variability.
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