title: Controlled portions of presweetened cereals present no glycemic penalty in persons with insulin-dependent diabetes mellitus.
abstract: OBJECTIVE
  To determine metabolic responses to commercially sweetened flaked corn cereal, unsweetened flaked corn cereal, glucose, and sucrose in teenagers and young adults with insulin-dependent diabetes mellitus (IDDM).
  
  
  METHODS
  A crossover design in which each subject consumed test meals in random order on 4 separate days at least 72 hours apart.
  
  
  METHODS
  The inpatient setting of the General Clinical Research Center of the Indiana University Medical Center Hospital.
  
  
  METHODS
  Sixteen males and eight females, aged 14 to 25 years, with IDDM.
  
  
  METHODS
  After fasting overnight, each subject underwent challenge tests with 50 g carbohydrate per 1.73 m2 of body surface area from sweetened flaked corn cereal, unsweetened flaked corn cereal, sucrose, and glucose. All subjects were maintained on continuous intravenous infusion of insulin overnight (euglycemic goal = 3.9 to 6.7 mmol/L), with a constant basal insulin dose infused before and throughout a 3-hour postprandial period.
  
  
  METHODS
  Plasma glucose, free insulin, triglycerides, and free fatty acid levels measured at baseline and 15, 30, 45, 60, 90, 120, 150, and 180 minutes after meals.
  
  
  METHODS
  Comparisons among the four meals were made using two-way repeated measures analyses of variance followed by the Newman-Keuls multiple comparison procedure to identify specific differences among meals. The areas under the response curves were compared using one-way repeated measures analysis of covariance, adjusted for baseline values.
  
  
  RESULTS
  The response to glucose for the area under the 3-hour blood glucose response curve was significantly greater than the response to sucrose (P = .006 by repeated measures analysis of variance); the areas for the two cereals (not significantly different from one another) were between the glucose and sucrose areas. At 3 hours, glycemia differed significantly among three of the meals: unsweetened flaked corn cereal > sweetened flaked corn cereal > sucrose (P < .001). Glucose at 3 hours was greater than sucrose (P < .001). There were no significant differences for free insulin, triglycerides, or free fatty acids.
  
  
  CONCLUSIONS
  Equivalent gram amounts of carbohydrate as presweetened breakfast cereals are not detrimental to persons with IDDM compared with unsweetened cereals. Therefore, presweetened cereals can be used in the correct portion sizes and based on the number of carbohydrate or starch servings in a person's diabetic meal plan.
authors.affiliation: Diabetes Research and Training Center (DRTC), Indiana University Medical Center, Indianapolis 46202, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Wheeler
authors.forename: S E
authors.initials: SE
authors.lastname: Fineberg
authors.forename: R
authors.initials: R
authors.lastname: Gibson
authors.forename: N
authors.initials: N
authors.lastname: Fineberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000009:adverse effects; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D013395:Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D014280:Triglycerides / Q000097:blood; D003313:Zea mays
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D014280:Triglycerides; D013395:Sucrose