Repository logo
 

Effect of nutrition on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully automated closed-loop insulin therapy.

Accepted version
Peer-reviewed

No Thumbnail Available

Type

Article

Change log

Authors

Piazza, Camillo 
Álvarez-Martínez, Mario 

Abstract

Fully automated closed-loop insulin delivery may offer a novel way to manage diabetes in hospital. However, postprandial glycaemic control remains challenging. We aimed to assess the effect of nutritional intake on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully closed-loop insulin therapy. The effects of different meal types and macronutrient composition on sensor glucose time-in-target (TIT, 3.9-10.0 mmol/L) and mean sensor glucose were assessed with hierarchical linear models using a Bayesian estimation approach. TIT was lower and the mean sensor glucose slightly higher, after breakfast compared with lunch and dinner, whereas the insulin dose was higher. Across meals, when carbohydrates were replaced by fat, or to a lesser extent by protein, postprandial glucose control improved. For breakfast, a 3.9% improvement in TIT was observed when 10% of the energy from carbohydrates was replaced by fat. Improvements were slightly lower during lunch and dinner (3.2% and 3.4%) or when carbohydrates were replaced by protein (2.2 and 2.7%, respectively). We suggest that reducing carbohydrate at the expense of fat or protein, could further improve glucose control during fully closed-loop insulin therapy in hospital.

Description

Keywords

glycaemic control, insulin therapy, type 2 diabetes, Bayes Theorem, Blood Glucose, Cross-Over Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Insulin, Insulin Infusion Systems, Meals, Postprandial Period

Journal Title

Diabetes Obes Metab

Conference Name

Journal ISSN

1462-8902
1463-1326

Volume Title

23

Publisher

Wiley

Rights

All rights reserved
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)