Carbohydrate counting at meal time followed by a small secondary postprandial bolus injection at 3 hours prevents late hyperglycemia, without hypoglycemia, after a high-carbohydrate, high-fat meal in type 1 diabetes
Open accessAbstract
adjustments at mealtime and administering additional bolus insulin units 3 h later provide similar postprandial glucose control to a meal containing negligible fat, without causing hypoglycemia.Patients should be advised that increasing the mealtime insulin dose alone is not an effective strategy and is an approach that may increase the risk of early postprandial hypoglycemia.
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Checking glucose 3 h after eating may help determine if additional insulin adjustments are required.
“Checking glucose 3 h after eating may help to determine if additional insulin adjustments (i.e., increasing or stopping bolus) are required (278,290).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [290]
The Abstract reports that an additional bolus at 3 hours after a high-carbohydrate, high-fat meal improved glucose control in people with type 1 diabetes. It describes a predetermined extra dose, however, not checking glucose at 3 hours to decide whether to increase or stop a bolus. (LLM, conf=0.83)
Experimental — accuracy not yet measuredChecking glucose 3 h after eating may help to determine if additional insulin adjustments are required.
“Checking glucose 3 h after eating may help to determine if additional insulin adjustments are required (i.e., increasing or stopping bolus) (185,192,193).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [193]
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Effect of fatty acids on glucose production and utilization in man.
Ferrannini, E., Barrett, E. J., Bevilacqua, S., & DeFronzo, R. A. (1983) · Journal of Clinical Investigation · doi:10.1172/jci111133 · Cited by 1,050 · see citing works
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Reduced oxidation of dietary fat after a short term high-carbohydrate diet
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Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report
Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., Mitri, J., Pereira, R. F., Rawlings, K., Robinson, S., et al. (2019) · Diabetes Care · doi:10.2337/dci19-0014 · Cited by 1,496 · see citing works
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- Authors
- Campbell, M. D., Walker, M., King, D., Gonzalez, J. T., Allerton, D., Stevenson, E. J., Shaw, J. A., & West, D. J.
- Affiliations
- Leeds Beckett University (GB)
- Newcastle University (GB)
- Northumbria University (GB)
- University of Bath (GB)
- Corresponding author
- West, Daniel J.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2016-06-28
- Volume
- 39
- Issue
- 9
- Pages
- e141-e142
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2466911283
- Cited by
- 32
- References
- 5
- Citations by year
- 2026: 1 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 1
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Leeds Beckett Repository (Leeds Beckett University) (acceptedVersion, other-oa)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Pure (University of Bath) (acceptedVersion, other-oa)
- The University of Bath Online Publications Store (The University of Bath) (submittedVersion)
- Northumbria Research Link (Northumbria University) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity) (cc-by-nc)
- Funders
- Northumbria University
- National Institute for Health and Care Research
- Newcastle University
- Medical Research Council (MR/L022699/1)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- carbohydrate counting, type 1 diabetes, high-fat meal, high-carbohydrate meal, hypoglycemia, postprandial glucose control
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