title: Safety of new algorithms for premeal insulin boluses in high glycaemic index meals in persons with type 1 diabetes mellitus using insulin pumps.
abstract: OBJECTIVE
  Consumption of glucose or foodstuffs with high glycaemic index (GI) in persons with type 1 diabetes mellitus (PWD1) is a hot topic in present diabetology. The aim of our pilot prospective study was to assess the efficiency of empirically suggested simple algorithms for premeal boluses in PWD1 using insulin pumps and continuous glucose monitoring (CGM).
  
  
  METHODS
  Six PWD1 (aged 46.2+/-15.09 y, diabetes duration 14.5+/-9.65 y, HbA1c/IFCC 6.3+/-1.59%, BMI 23.6+/-1.67 kg/m(2), mean+/-SD) on insulin pumps Paradigm 522/722 with RT-CGMS sensors (Medtronic MiniMed, Northridge, CA) underwent a 12-week CGM. In one week, subjects consumed 50 g of carbohydrates in eleven alternative meals (rice squares, dark chocolate, white bread, honey, glucose, ravioli with meat and Eidam cheese, mashed potatoes with fish fingers, apricot dumplings with butter, spa waffles, spalta squares, and tomato soup with pasta) eaten for breakfasts, lunches, snacks and dinners in order to calculate their GI. The insulin boluses were adjusted according to empirically defined algorithms. Average glucose levels and daily insulin doses over three one-week periods (before testing, testing and after testing) were compared.
  
  
  RESULTS
  During the observational period, the weekly averages of glucose levels (9.1+/-2.33 mmol/l vs. 9.2+/-2.30 mmol/l vs. 9.0+/-2.43 mmol/l, respectively) and daily insulin doses (39.1+/- 8.14 IU/d vs. 39.7+/-10.7 IU/d vs. 38.6+/-9.97 IU/d, respectively) were similar. One-week consumption of high GI foodstuffs had only a negligeable effect on average glucose levels.
  
  
  CONCLUSIONS
  The suggested algorithms for premeal insulin boluses appear to limit the risk of potential hyperglycaemia resulting from intake of high GI foodstuffs.
authors.affiliation: Department of Physiology, 2nd Department of Medicine, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic. natalia.lippaiova@seznam.cz
authors.forename: Natalia
authors.initials: N
authors.lastname: Lippaiova
authors.forename: Maria
authors.initials: M
authors.lastname: Pallayova
authors.forename: Galina
authors.initials: G
authors.lastname: Kuzmina
authors.forename: Karolina
authors.initials: K
authors.lastname: Peterson
authors.forename: Lucie
authors.initials: L
authors.lastname: Fajkosova
authors.forename: Jiri
authors.initials: J
authors.lastname: Luza
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin