Objectives: Last year we observed that the best bolus for a pizza margherita meal is 30/70 dual wave bolus (DWB) extended over 6 hours. Because of this, we start to consider that for a “Mediterranean” meal (MM) a DWB might be better than a simple bolus (SB). We compare a SB with different kind of DWB in order to identify the optimal one in case of a MM. Methods: We evaluated 26 children, aged 5-23 years (mean 15.4 ± 4.8 years) with T1DM from 9.7 ± 4.9 years, BMI 22.0 ± 4.4 kg/m2, with CSII (insulin requirement 0.76 ± 0.14 U/kg/day). Each patient utilized the following 6 aspart regimens on 3 consecutive days, and glucose values were recorded with SMBG: a) a SB (100% of insulin (I) given immediately) injected 15 min before meal; b) a SB (100% of I given immediately) injected just before meal; c) 4-hour DWB (50% of I given immediately and 50% given over a 4-hour period) injected 15 min prior meal; d) 4-hour DWB (50% of I give immediately and 50% given over a 4-hour period) injected just before meal; e) 4-hour DWB (70% given immediately and 30% given over a 4-hour period) injected 15 min before meal; and f) 4-hour DWB (70% given immediately and 30% given over a 4-hour period) injected just before meal. Total CHO was kept constant for each meal; I dose was calculated according to glycaemic value and CHO, using ISF and INS : CHO ratio, personalized for each patient. Results: Conclusion: 70/30 DWB extended over 4-hour period following a MM injected 15 minutes before provided significantly less postprandial hyperglycemia during the 4-hour period. SB could be used only if given 15 minutes before meal, even if we observed a rise in glycaemic values in the last 2 hours of the study.
The optimal type of bolus following a “Mediterranean” meal in children and adolescents with type 1 diabetes (T1DM) using insulin pump therapy (CSII) / A.E. Scaramuzza, D. Iafusco, M. Macedoni, D. Spiri, A. Bosetti, E. Giani, A. De Palma, A. Gazzarri, C. Mameli, S. Mazzantini, L. Santoro, G.V. Zuccotti. - In: PEDIATRIC DIABETES. - ISSN 1399-543X. - 10:Suppl. 11(2009), pp. 104-104. ((Intervento presentato al 35. convegno Annual meeting of the International Society for Pediatric and Adolescent Diabetes tenutosi a Ljubljana nel 2009.
|Titolo:||The optimal type of bolus following a “Mediterranean” meal in children and adolescents with type 1 diabetes (T1DM) using insulin pump therapy (CSII)|
SANTORO, LAURA (Penultimo)
ZUCCOTTI, GIAN VINCENZO (Ultimo)
|Settore Scientifico Disciplinare:||Settore MED/38 - Pediatria Generale e Specialistica|
|Data di pubblicazione:||2009|
|Enti collegati al convegno:||ISPAD International Society for Pediatric and Adolescent Diabetes|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/j.1399-5448.2009.00554.x|
|Appare nelle tipologie:||01 - Articolo su periodico|