title: Absorption patterns of meals containing complex carbohydrates in type 1 diabetes.
abstract: OBJECTIVE
  Successful postprandial glycaemia management requires understanding of absorption patterns after meals containing variable complex carbohydrates. We studied eight young participants with type 1 diabetes to investigate a large low-glycaemic-load (LG) meal and another eight participants to investigate a high-glycaemic-load (HG) meal matched for carbohydrates (121 g).
  
  
  METHODS
  On Visit 1, participants consumed an evening meal. On follow-up Visit 2, a variable-target glucose clamp was performed to reproduce glucose and insulin levels from Visit 1. Adopting stable-label tracer dilution methodology, we measured endogenous glucose production on Visit 2 and subtracted it from total glucose appearance measured on Visit 1 to obtain meal-attributable glucose appearance.
  
  
  RESULTS
  After the LG meal, 25%, 50% and 75% of cumulative glucose appearance was at 88 ± 21, 175 ± 39 and 270 ± 54 min (mean ± SD), whereas glucose from the HG meal appeared significantly faster at 56 ± 12, 100 ± 25 and 153 ± 39 min (p < 0.001 to 0.003), and resulted in a 50% higher peak appearance (p < 0.001). Higher apparent bioavailability by 15% (p = 0.037) was observed after the LG meal. We documented a 20 min deceleration of dietary mixed carbohydrates compared with dietary glucose for the HG meal and a twofold deceleration for the LG meal.
  
  
  CONCLUSIONS
  Absorption patterns may be influenced by glycaemic load and/or meal composition, affecting optimum prandial insulin dosing in type 1 diabetes.
authors: University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science, Box 289, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.
authors: D
authors: D
authors: Elleri
authors: J M
authors: JM
authors: Allen
authors: J
authors: J
authors: Harris
authors: K
authors: K
authors: Kumareswaran
authors: M
authors: M
authors: Nodale
authors: L
authors: L
authors: Leelarathna
authors: C L
authors: CL
authors: Acerini
authors: A
authors: A
authors: Haidar
authors: M E
authors: ME
authors: Wilinska
authors: N
authors: N
authors: Jackson
authors: A M
authors: AM
authors: Umpleby
authors: M L
authors: ML
authors: Evans
authors: D B
authors: DB
authors: Dunger
authors: R
authors: R
authors: Hovorka
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000009:adverse effects / Q000378:metabolism* / Q000627:therapeutic use; D005260:Female; D005943:Gluconeogenesis; D015309:Glucose Clamp Technique; D038321:Glycemic Index; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000097:blood / Q000627:therapeutic use; D007201:Indicator Dilution Techniques; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D007408:Intestinal Absorption; D008297:Male; D062407:Meals; D008954:Models, Biological; D019518:Postprandial Period; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007004:Hypoglycemic Agents; D007328:Insulin