title: Carbohydrate intake is associated with time spent in the euglycemic range in patients with type 1 diabetes.
abstract: OBJECTIVE
  Greater glycemic variability and lack of predictability are important issues for patients with type 1 diabetes. Dietary factors are one of the contributors to this variability, but how closely diet is linked to glycemic fluctuation on a daily basis has not been investigated. We examined the association between carbohydrate intake and glycemic excursion in outpatients.
  
  
  METHODS
  A total of 33 patients with type 1 diabetes were included in the analyses (age 44.5 ± 14.7 years, diabetes duration 15.1 ± 8.3 years, 64% female, 30% using insulin pump, glycated hemoglobin 8.1 ± 1.3%). Time spent in euglycemia (70-180 mg/dL), hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) of consecutive 48-h periods of continuous glucose monitoring data were collected together with simultaneous records of dietary intake, insulin dose and physical activity. Correlation analyses and multiple regression analyses were used to evaluate the contribution of carbohydrate intake to time spent in the target glycemic range.
  
  
  RESULTS
  In multiple regression analyses, carbohydrate intake (β = 0.53, P = 0.001), basal insulin dose per kg per day (β = -0.31, P = 0.034) and diabetes duration (β = 0.30, P = 0.042) were independent predictors of time spent in euglycemia. Carbohydrate intake (β = -0.51, P = 0.001) and insulin pump use (β = -0.34, P = 0.024) were independent predictors of time spent in hyperglycemia. Insulin pump use (β = 0.52, P < 0.001) and bolus insulin dose per kg per day (β = 0.46, P = 0.001) were independent predictors of time spent in hypoglycemia.
  
  
  CONCLUSIONS
  Carbohydrate intake is associated with time spent in euglycemia in patients with type 1 diabetes.
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University Kyoto, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Ayano-Takahara
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University Kyoto, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University Kyoto, Japan ; Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University Kochi, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: Department of Metabolism and Clinical Nutrition, Kyoto University Hospital Kyoto, Japan.
authors.forename: Kanae
authors.initials: K
authors.lastname: Asai
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University Kyoto, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Oguri
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University Kyoto, Japan.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Harashima
authors.affiliation: Department of Metabolism and Clinical Nutrition, Kyoto University Hospital Kyoto, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Tsuji
authors.affiliation: Department of Metabolism and Clinical Nutrition, Kyoto University Hospital Kyoto, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Shide
authors.affiliation: Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University Kyoto, Japan.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Inagaki
keywords: Dietary carbohydrates; Glycemic control; Type 1 diabetes mellitus