Effects of fat supplementation on glycaemic response and gastric emptying in adolescents with Type 1 diabetes
Effects of fat supplementation on glycaemic response and gastric emptying in adolescents with Type 1 diabetes
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DOI：
10.1111/j.1464-5491.2008.02530.x
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发表时间：
2008-09-01
影响因子：
3.5
通讯作者：
Bang, P.
中科院分区：
文献类型：
--
作者：
Lodefalk, M.;Amant, J.;Bang, P.
目的比较青少年1型糖尿病(T1 DM)患者对不同脂肪含量膳食的血糖反应，并探讨其与胃排空的关系。方法采用随机、交叉研究方法，对7名T1 DM青少年在不同天数进食相同碳水化合物和蛋白质含量，但脂肪和能量含量不同(脂肪2和38g，热量分别为320和640千卡)的两餐进行配对研究。将扑热息痛混合到膳食中，用扑热息痛吸收法测定胃排空。所有受试者血糖正常，并在开始摄入时给予7IU胰岛素。结果低脂餐后前2 h血糖和血清对乙酰氨基酚浓度曲线下面积均大于高脂餐后(P=0.047和P=0.041)。两餐间血糖达峰时间和对乙酰氨基酚浓度差异无统计学意义(高脂餐和低脂餐：210min(120-240)对120min(50-240)，P=0.080和120min(75-180)对60min(60-120))。P=0.051)。血糖浓度的变化与对乙酰氨基酚浓度的同步变化相关(P<；0.001)。结论我们首次表明，在青少年T1 DM患者餐前给予快速作用的胰岛素类似物后，与低脂肪含量的饮食相比，高脂肪饮食后的初始血糖反应降低。餐前胰岛素的类型和剂量可能需要调整到餐后脂肪含量以达到餐后正常血糖。
Aims To compare the glycaemic response to meals with different fat content in adolescents with Type 1 diabetes mellitus (T1DM) and to investigate associations with gastric emptying.Methods In this randomized, cross-over study, paired results were obtained from seven adolescents with T1DM who ingested on different days two meals with the same carbohydrate and protein content, but different fat and energy content (2 and 38 g fat, 320 and 640 kcal, respectively). Paracetamol was mixed into the meals and gastric emptying was estimated by the paracetamol absorption method. All subjects were normnoglycaemic and given 7 IU insulin aspart at commencement of ingestion. Postprandial blood samples were taken during 4 h.Results The areas under the curves for plasma glucose and serum paracetamol concentrations were larger after the low-fat than after the high-fat meal during the first 2 h (P = 0.047 and P = 0.041, respectively). The difference between meals in time-to-peak in glucose and paracetamol concentrations did not reach statistical significance (high-fat vs. low-fat meal: 210 min (120-240) vs. 120 min (50-240), P = 0.080 and 120 min (75-180) vs. 60 min (60-120). P = 0.051, respectively). Changes in glucose concentrations correlated with simultaneous changes in paracetamol concentrations (P < 0.001).Conclusions For the first time, we have shown that the initial glycaemic response is reduced after a meal with higher compared with a meal with lower fat content in adolescents with T1DM given a rapid-acting insulin analogue preprandially. The type and dose of preprandial insulin may need adjustment to the fat content of the meal to reach postprandial normoglycaemia.