The snack is critical for the blood glucose profile during treatment with regular insulin preprandially.
OBJECTIVE
To evaluate how a snack influences the blood glucose profile during treatment with preprandial regular human insulin.


METHODS
In a randomized study a mid-morning snack either was or was not served. Insulin was given 30 min before the usual breakfast of the patients. Plasma free insulin and blood glucose were repeatedly determined for 5 h.


METHODS
Outpatient clinic at a university hospital.


METHODS
Twenty patients with type 1 diabetes treated with multiple injections of regular insulin (Actrapid) and eight non-diabetic subjects.


METHODS
A mid-morning snack either was or was not served 2 h after the usual morning insulin injection.


METHODS
A difference in the blood glucose profile after a mid-morning snack.


RESULTS
With a snack there was no difference in blood glucose fasting and at 12.30 h, whilst without a snack there was a decrease of almost 4 mmol L-1, several patients experienced low blood glucose and three had hypoglycaemia. An extended peak of free insulin was reached 30 min after the insulin injection with a slow decrease to the fasting level after 5 h. After the insulin injection a significant decrease in blood glucose occurred within 30-45 min.


CONCLUSIONS
A snack 2 h after the insulin injection results in a smoother blood glucose profile and reduces the risk of hypoglycaemia in patients with type 1 diabetes treated with preprandial regular human insulin. Furthermore, the recommended interval of 30 min between insulin injection and a meal may be too long.
Orre-Pettersson
A C
AC
Department of Internal Medicine, Faculty of Health Sciences, University Hospital, Linköping, Sweden. ann-charlotte.orre-pettersson@end.us.lio.se
Lindström
T
T
Bergmark
V
V
Arnqvist
H J
HJ
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005502:Food; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000097:blood / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin