title: Comparison of the ability of bread versus bread plus meat to treat and prevent subsequent hypoglycemia in patients with insulin-dependent diabetes mellitus.
abstract: We sought to determine whether treatment of hypoglycemia with a snack containing both protein and carbohydrate results in more prolonged protection against subsequent hypoglycemia than ingestion of carbohydrate alone. We studied six insulin-dependent diabetic subjects on two occasions. On both occasions subjects received a variable overnight insulin infusion to achieve euglycemia followed by a constant insulin infusion (approximately 0.5 mU x kg(-1) x min(-1)) designed to produce hypoglycemia. When glucose reached 50 mg/dL, subjects were fed a snack consisting of either bread (approximately 85 kcal) or bread plus meat (approximately 205 kcal). Both contained 15 g of carbohydrate. The insulin infusion was continued for the next 3 h or until glucose again fell to 50 mg/dL. Although bread plus meat resulted in a more marked rise (P < 0.05) in glucagon than did bread alone, neither the post treatment peak glucose concentration (73 +/- 4 vs. 70 +/- 6 mg/dL) nor the subsequent rate of fall of glucose (0.42 +/- 0.10 us. -0.35 +/- 0.07 mg/dL/min) differed. The present study shows that the rate of redevelopment of hypoglycemia does not differ after eating bread or bread plus meat. Therefore treatment of hypoglycemia with a protein-enriched snack merely adds calories rather prolonged protection against subsequent hypoglycemia.
authors.affiliation: Endocrine Research Unit, Department of Medicine, Rochester, Minnesota 55905, USA.
authors.forename: R O
authors.initials: RO
authors.lastname: Gray
authors.forename: P C
authors.initials: PC
authors.lastname: Butler
authors.forename: T R
authors.initials: TR
authors.lastname: Beers
authors.forename: E J
authors.initials: EJ
authors.lastname: Kryshak
authors.forename: R A
authors.initials: RA
authors.lastname: Rizza
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001939:Bread; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000178:diet therapy / Q000188:drug therapy*; D002149:Energy Intake; D005260:Female; D005934:Glucagon / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007003:Hypoglycemia / Q000178:diet therapy / Q000517:prevention & control*; D007328:Insulin / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D008297:Male; D008460:Meat; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013006:Growth Hormone; D005934:Glucagon; D006854:Hydrocortisone