ESPE Abstracts

Background: In the light of emerging recent researches and the use of continuous glucose monitoring it was shown that other nutritional properties of food, including fat, protein, and glycemic index (GI), can significantly affect postprandial glucose excursions. These findings highlight the need for alternative mealtime insulin dosing algorithms and have important implications for nutrition education and counseling in patients with diabetes.

Objective and hypothesis: The current study was conducted to determine the effect of high protein and fat content on postprandial glycemic response in Egyptian children and adolescents with type 1 diabetes

Patients and method: Each patient was served each of three breakfast meals on three separate days; the standard meal, high protein meal 31.25 gm (with extra 125 kcal protein) and high fat meal (with extra 125 kcal fat). Blood glucose was measured preprandial and every half an hour for 5 hours after each kind of meals using caliberated glucometer. The preprandial blood glucose values before the three test meals were comparable which allowed the testing of the effect.

Results: The current study included 51 children and adolescents with type 1 diabetes following up at Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), at Children’s hospital, Cairo University. The age of the patients ranged from 6 to 18 years (11.24±2.413) with a mean diabetes duration of 4.76. After the standard meal, the blood glucose started to rise gradually till reached its peak at 3 hours postprandial then decreased gradually till the end of 5 hours but didn’t reach the preprandial level. After high protein meal (31.25 gm protein); plasma glucose levels gradually rose post prandial till reached peak glucose excursion at 4.5hrs, then started to decline at 5 hours but didn’t reach the preprandial level. However after high fat meal, the blood glucose levels rose to reach a peak level at 2 hours then started to decline gradually to reach the preprandial level at 5 hours.

Conclusion: Protein and fat contents of meals affect the timing and values of the peak excursion of blood glucose as well as the duration of postprandial hyperglycemia. Therefore fat protein unit should be taken in consideration in calculating the bolus insulin dose and the anticipation of postprandial glucose response.

Keywords: Type 1 diabetes, high fat meal, high protein meal, post prandial glycemia