title: Low-fat vs. high-fat bedtime snacks in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  The purpose of this study was to determine whether, in a group of children with type 1 diabetes using insulin pump, a prebedtime snack with a relatively high fat content provides greater protection from nocturnal hypoglycemia than a snack containing the same amount of carbohydrate and protein but a lower fat content.
  
  
  METHODS
  Ten subjects, aged 6 to <18 yr, in a trial evaluating the Abbott Navigator glucose sensor, agreed to this ancillary study. On 12 or more separate nights, each subject was randomized by a Web site to a carbohydrate-low-fat (30 g CHO, 2.5 g protein, and 1.3 g fat; 138 kcal) snack or a carbohydrate-high-fat (30 g CHO, 2 g protein, and 20 g fat; 320 kcal) snack. Subjects used their usual evening snack algorithm to determine the size (in 15-g carbohydrate increments) and insulin dosage.
  
  
  RESULTS
  Average glucose on 128 valid study nights before snack was similar in both groups. The proportion of nights with hypoglycemia (a sensor or meter glucose value <or=70 mg/dL) was similar in both groups (19% high fat vs. 20% low fat), as was the proportion of nights with hyperglycemia (a glucose >or=200 mg/dL and at least 50 mg/dL above baseline, 35% high fat vs. 30% low fat).
  
  
  CONCLUSIONS
  There were no statistical differences between the high- and low-fat snacks on the frequency of hyperglycemia or hypoglycemia. This study highlights the feasibility of web-based research in patients' home environment.
authors.affiliation: Division of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, CA, USA. direcnet@jaeb.org
authors.forename: Darrell
authors.initials: D
authors.lastname: Wilson
authors.forename: H Peter
authors.initials: HP
authors.lastname: Chase
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Dongyuan
authors.initials: D
authors.lastname: Xing
authors.forename: Kimberly
authors.initials: K
authors.lastname: Caswell
authors.forename: Michael
authors.initials: M
authors.lastname: Tansey
authors.forename: Larry
authors.initials: L
authors.lastname: Fox
authors.forename: Stuart
authors.initials: S
authors.lastname: Weinzimer
authors.forename: Roy
authors.initials: R
authors.lastname: Beck
authors.forename: Katrina
authors.initials: K
authors.lastname: Ruedy
authors.forename: William
authors.initials: W
authors.lastname: Tamborlane