Meal intolerance in type 1 diabetes mellitus: influence of time interval between insulin therapy and meal intake.
Post-prandial hyperglycemia or meal intolerance has been documented in a majority of patients with Type I Diabetes Mellitus (IDDM) receiving conventional insulin treatment. It is most marked following the breakfast meal. We hypothesized that the abnormality might result from insulin insufficiency because of the short time interval between insulin therapy and meal ingestion. To test this hypothesis a standardized breakfast was fed 30 min. after insulin on one day and 90 min. after insulin on the alternate day. Plasma concentrations of glucose, free insulin and cortisol were measured at 30 min. intervals throughout the study period. A control population consisted of healthy children who were fed the same standardized breakfast. We observed that prolongation of the time period between insulin and meal did not alter the magnitude of the post-meal rise in glucose concentration in the IDDM group. Furthermore, meal intolerance persisted despite the significantly higher pre-meal levels of insulin in the IDDM group compared to the controls. We speculate that a defect in insulin action may be responsible for the phenomenon of meal intolerance in the Type I diabetics given subcutaneous insulin injections once or twice daily.
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005502:Food; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D007700:Kinetics; D008297:Male; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D006854:Hydrocortisone