scholarly journals Accurate Carbohydrate Counting Is an Important Determinant of Postprandial Glycemia in Children and Adolescents With Type 1 Diabetes on Insulin Pump Therapy

2016 ◽  
Vol 11 (4) ◽  
pp. 753-758 ◽  
Author(s):  
Asma Deeb ◽  
Ahlam Al Hajeri ◽  
Iman Alhmoudi ◽  
Nico Nagelkerke
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Postprandial Glucose ◽  
Meal Size ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Postprandial Glycemia ◽  
The Impact

Background: Carbohydrate (CHO) counting is a key nutritional intervention utilized in the management of diabetes to optimize postprandial glycemia. The aim of the study was to examine the impact of accuracy of CHO counting on the postprandial glucose in children and adolescents with type 1 diabetes on insulin pump therapy. Methods: Children/adolescents with type 1 diabetes who were on insulin pump therapy for a minimum of 6 months are enrolled in the study. Patients were instructed to record details of meals consumed, estimated CHO count per meal, and 2-hour postprandial glucose readings over 3-5 days. Meals’ CHO contents were recounted by an experienced clinical dietician, and those within 20% of the dietician’s counting were considered accurate. Results: A total of 30 patients (21 females) were enrolled. Age range (median) was 8-18 (SD 13) years. Data of 247 meals were analyzed. A total of 165 (67%) meals’ CHO contents were accurately counted. Of those, 90 meals (55%) had in-target postprandial glucose ( P < .000). There was an inverse relationship between inaccurate CHO estimates and postprandial glucose. Of the 63 underestimated meals, 55 had above-target glucose, while 12 of the 19 overestimated meals were followed by low glucose. There was no association between accuracy and meal size (Spearman’s rho = .019). Conclusion: Accuracy of CHO counting is an important determining factor of postprandial glycemia. However, other factors should be considered when advising on prandial insulin calculation. Underestimation and overestimation of CHO result in postprandial hyperglycemia and hypoglycemia, respectively. Accuracy does not correlate with meal size.

Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait

2019 ◽  
Vol 32 (8) ◽  
pp. 843-849 ◽  
Author(s):  
Kholoud Mohamed ◽  
Dalia Al-Abdulrazzaq ◽  
Amel Fayed ◽  
Eman El Busairi ◽  
Faisal Al Shawaf ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Control Level ◽  
Insulin Pump Therapy ◽  
Insulin Regimen ◽  
Pump Therapy ◽  
Significant Difference

Abstract Background To evaluate the safety of fasting during the holy month of Ramadan among children and adolescent with type 1 diabetes (T1D). Methods A retrospective cohort study of 50 children and adolescents with T1D whose mean age was 12.7 ± 2.1 years was conducted. Twenty-seven patients (54%) were on multiple daily injections (MDI) insulin regimen and 23 (46%) were on insulin pump therapy. Before fasting for Ramadan, children and their families were evaluated and educated about diabetes management during Ramadan. Hemoglobin A1c (HbA1c), weight, number of days fasted, hypoglycemia and hyperglycemia episodes, and emergency hospital visits were collected and analyzed after completing the month. Participants were compared according to the insulin treatment regimen and their glycemic control level before Ramadan. Results The children were able to fast 20 ± 9.9 days of Ramadan, and the most common cause for breaking the fast was mild hypoglycemia (7.8% among all cases). There was no significant difference between the two insulin regimen groups in breaking fast days, frequency of hypo- or hyperglycemia, weight and HbA1c changes post Ramadan. Patients with HbA1c ≤ 8.5% were able to fast more days during Ramadan with significantly less-frequent hypoglycemic attacks as compared to patients with HbA1c > 8.5 (1.2 ± 1.5 vs. 3.3 ± 2.9 days of hypoglycemia, p = 0.01, respectively). Conclusions Fasting for children with T1D above the age of 10 years is feasible and safe in both pump and non-pump users, and well-controlled patients are less likely to develop complications. Education of the families and their children before Ramadan, along with intensive monitoring of fasting children during the month are crucial.

scholarly journals The Effectiveness and Durability of an Early Insulin Pump Therapy in Children and Adolescents with Type 1 Diabetes Mellitus

2014 ◽  
Vol 16 (11) ◽  
pp. 735-741 ◽  
Author(s):  
Davide Brancato ◽  
Mattia Fleres ◽  
Vito Aiello ◽  
Gabriella Saura ◽  
Alessandro Scorsone ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy

scholarly journals Safety and Effectiveness of Insulin Pump Therapy in Children and Adolescents With Type 1 Diabetes

Diabetes Care ◽  
2003 ◽  
Vol 26 (4) ◽  
pp. 1142-1146 ◽  
Author(s):  
L. P. Plotnick ◽  
L. M. Clark ◽  
F. L. Brancati ◽  
T. Erlinger
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy

scholarly journals Exercise effects on postprandial glucose metabolism in type 1 diabetes: a triple-tracer approach

2015 ◽  
Vol 308 (12) ◽  
pp. E1106-E1115 ◽  
Author(s):  
Ashwini Mallad ◽  
Ling Hinshaw ◽  
Michele Schiavon ◽  
Chiara Dalla Man ◽  
Vikash Dadlani ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Metabolism ◽  
Insulin Pump ◽  
Postprandial Glucose ◽  
Insulin Pump Therapy ◽  
Moderate Intensity ◽  
Glucose Turnover ◽  
Moderate Intensity Exercise ◽  
Pump Therapy

To determine the effects of exercise on postprandial glucose metabolism and insulin action in type 1 diabetes (T1D), we applied the triple tracer technique to study 16 T1D subjects on insulin pump therapy before, during, and after 75 min of moderate-intensity exercise (50% V̇o2max) that started 120 min after a mixed meal containing 75 g of labeled glucose. Prandial insulin bolus was administered as per each subject's customary insulin/carbohydrate ratio adjusted for meal time meter glucose and the level of physical activity. Basal insulin infusion rates were not altered. There were no episodes of hypoglycemia during the study. Plasma dopamine and norepinephrine concentrations rose during exercise. During exercise, rates of endogenous glucose production rose rapidly to baseline levels despite high circulating insulin and glucose concentrations. Interestingly, plasma insulin concentrations increased during exercise despite no changes in insulin pump infusion rates, implying increased mobilization of insulin from subcutaneous depots. Glucagon concentrations rose before and during exercise. Therapeutic approaches for T1D management during exercise will need to account for its effects on glucose turnover, insulin mobilization, glucagon, and sympathetic response and possibly other blood-borne feedback and afferent reflex mechanisms to improve both hypoglycemia and hyperglycemia.

scholarly journals Insulin pump therapy of type 1 diabetes mellitus in children and adolescents in the Moscow region

2009 ◽  
Vol 12 (3) ◽  
pp. 60-63
Author(s):  
Elena Efimovna Petryaykina ◽  
Olga Viktorovna Dukhareva ◽  
Irina Georgievna Rybkina ◽  
Ekaterina Alexandrovna Pronina ◽  
Tatiana Dmitrievna Mikhaylova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Daily Insulin Dose

Aim. To assess dynamics of glycated hemoglobin levels and insulin doses per kg bw in children and adolescents with poorly controlled type 1 diabetes mellitus using insulin pumps. Materials and methods. Retrospective analysis of HbA1c levels and insulin doses per kg bw in children aged 2-17 years with DM1 (mean duration 5.3?3.1) before and 18 months after onset of insulin pump therapy (Medtronic Minimed 712 and 722) with a short-acting insulin analog Novopramid (Novo Nordisk) or Humalog (Ely Lilly) given to 55 (52,4%) and 50 (47,6%) of the patients respectively. НbА1с level and mean daily insulin dose per kg bw were determined when a patient visited the doctors office every 3 months. Results. Insulin pump therapy in patients with initially poorly controlled DM1 resulted in a decrease of HbA1c from 9.8?0.8 to 7,8?0,5% within 18 months after its beginning (p

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