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Cited by 1Diabetes Management and ResearchFood composition and propertiesDiabetes Treatment and Management

Does Resistant Starch Formed by Cooling Pasta Decrease the Postprandial Glycemic Response in Type 1 Diabetes? A Randomized Single-Blind Crossover Study

Open access
Rogowicz-Frontczak, Anita, Strozyk, Sylwia, Pilacinski, Stanislaw, Koperska, Anna, Le Thanh-Blicharz, Joanna, Tanska, Magdalena, Zozulinska-Ziolkiewicz, Dorota·2026·Nutrients
DOI 10.3390/nu18071152PMC PMC13074698
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Abstract

Background: Carbohydrate quality and culinary processing can meaningfully alter postprandial glycemia in people with type 1 diabetes (T1D). Cooling gelatinized starch promotes retrogradation and increases resistant starch (RS), potentially attenuating postprandial glucose excursions. Objectives: We investigated whether pasta cooled after cooking (24 h at 4 °C) and reheated before consumption improves postprandial glycemia in adults with T1D without increasing hypoglycemia risk under routine insulin pump bolus-calculator dosing. Methods: In this randomized, single-blind, crossover study, 32 adults with T1D treated with continuous subcutaneous insulin infusion (CSII) consumed two standardized pasta-based meals (50 g of available carbohydrate): freshly cooked pasta and cooled/reheated pasta. Participants administered rapid-acting insulin boluses calculated by their pump bolus calculator 10 min before the meal. Interstitial glucose was recorded for 180 min using flash glucose monitoring. Results: Compared with freshly cooked pasta, cooled/reheated pasta produced lower maximum glycemia (10.7 vs. 12.6 mmol/L, p = 0.0001), lower maximum glycemic rise (2.8 vs. 4.7 mmol/L, p < 0.0001), lower incremental area under the curve (iAUC; 211.9 vs. 524.8 mmol/L × 180 min, p < 0.0001), and a shorter time-to-peak (65 vs. 125 min, p = 0.014). Resistant starch content increased after cooling (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g). The number of hypoglycemic episodes did not differ between conditions. Conclusions: Cooling and reheating pasta therefore increased RS and attenuated postprandial glycemia in adults with T1D without increasing early postprandial hypoglycemia in the studied setting.

AI snapshot

Written from the paper’s full text.

TL;DR

In 32 adults with type 1 diabetes using CSII, pasta cooled for 24 h at 4 °C and reheated before eating increased resistant starch and reduced early postprandial glucose excursions versus freshly cooked pasta under routine pump bolus-calculator dosing. Hypoglycemia did not differ between meals in this exploratory single-center crossover study.

Key findings

  • Cooled/reheated pasta lowered maximum glycemia (10.7 vs. 12.6 mmol/L, p = 0.0001), maximum glycemic rise (2.8 vs. 4.7 mmol/L, p < 0.0001), 180-min iAUC (211.9 vs. 524.8 mmol/L × 180 min, p < 0.0001), and time-to-peak (65 vs. 125 min, p = 0.014).
  • Resistant starch content increased after cooling/reheating (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g).
  • Postprandial hypoglycemic episodes within 180 min did not differ: 1 participant (3.1%) after fresh pasta at 170 min; 2 participants (6.3%) after cooled/reheated pasta at 90 and 150 min.
  • Insulin bolus and basal doses were comparable (bolus 5.3 [5.0–6.0] vs. 5.4 [4.9–6.0] units, p = 0.83; basal 15.8 [13.2–19.9] units both, p = 0.42); organoleptic ratings were similar, and appetite differences at 120 min were exploratory.

Methods

  • Randomized, single-blind, crossover trial in 32 adults with T1D on CSII; two standardized pasta meals (50 g available carbohydrate) consumed in randomized order at least 7 days apart at 14:00 after a 5 h fast; rapid-acting insulin bolus calculated by pump bolus calculator 10 min before each meal.
  • Freshly cooked wheat pasta vs. pasta cooked, cooled for 24 h at 4 °C, and reheated; resistant starch measured by AOAC 2002.02; interstitial glucose recorded for 180 min with FreeStyle Libre 2.
  • Primary endpoint was 180-min iAUC; paired t-tests or Wilcoxon signed-rank tests, two-sided p < 0.05; no formal correction for multiple comparisons and no formal period/carry-over testing.

Limitations

  • The paper states it was exploratory, single-center, investigator-initiated, with no a priori sample size calculation and a pragmatic sample size; it was not prospectively registered; no formal correction for multiple comparisons and no formal period/carry-over testing were performed.
  • The paper states interstitial glucose lag may affect absolute peak and time-to-peak; participants could view sensor readings, potentially compromising blinding; only one pasta type and cooling protocol were tested; the 180-min observation missed later excursions, delayed hypoglycemia, time-in-range, time-above-range, and short-term variability; standardized meal conditions may not reflect real-world eating.
  • Evident from the text: the single-blind design did not prevent participants from seeing sensor glucose, and the exploratory design with no a priori sample size calculation limits confirmatory inference; these points are also acknowledged by the authors.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/nu18071152

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

21 of 37 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Two meals containing the same amount of carbohydrate can elicit different glycemic responses because of differences in food structure, processing, starch fractions, and non-carbohydrate components.

    “two meals containing the same amount of carbohydrate can elicit different glycemic responses because of differences in food structure, processing, starch fractions (rapidly available vs. slowly available), and the effect of non-carbohydrate components (fat, protein, fiber) on gastric emptying and intestinal digestion [4,5,6,7].”
    Quote in the paperSubstantial claim1 of 4 sources checked
    • cites [4] Cai, 2021, The impact of starchy food structure on postprandial glycemic response and appetite: A systematic review and meta-analysis, Am. J. Clin. Nutr. source

      The Discussion (Overall summary and Relevance of this systematic review; page unavailable) says starchy foods with similar nutrient composition can produce different glycemic responses because of structure, processing, and starch-related factors. It also names dietary fiber as a possible contributor to variation. The paper does not establish the sentence’s further claim that fat, protein, and fiber alter glycemic responses through effects on gastric emptying and intestinal digestion. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [5] Englyst, 1992, Classification and measurement of nutritionally important starch fractions, Eur. J. Clin. Nutr.
    • cites [6] Granfeldt, 2006, Determination of glycaemic index; some methodological aspects related to the analysis of carbohydrate load and characteristics of the previous evening meal, Eur. J. Clin. Nutr. source
    • cites [7] Schmidt, 2014, Bolus calculators, J. Diabetes Sci. Technol. source
  • Premisecitation

    Matching insulin action to the time course of glucose appearance after meals remains challenging, particularly with starchy foods.

    “matching insulin action to the time course of glucose appearance after meals remains challenging, particularly with starchy foods [3,4].”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [3] American Diabetes Association Professional Practice Committee (2025). Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2025. Diabetes Care, 48, S128–S145. source

      The Hypoglycemia Treatment section says that added fat may slow and prolong the glycemic response to food and that insulin may remain active after recovery from hypoglycemia. It does not address the difficulty of matching insulin action to postmeal glucose appearance, particularly for starchy foods. Searches for that phrasing and for starch, insulin timing, and carbohydrate absorption found no passage establishing the claim; page numbers were not available in our copy. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [4] Cai, 2021, The impact of starchy food structure on postprandial glycemic response and appetite: A systematic review and meta-analysis, Am. J. Clin. Nutr. source

      The Introduction (page unavailable) says the rate of starch digestion affects postprandial glucose responses, and the Discussion, “Food structure and glucose and insulin response” (page unavailable), links digestion rate to both glucose and insulin responses. These passages support the relevance of starchy foods, but they do not say that matching insulin action to the timing of glucose appearance is challenging. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    The absolute and relative increase in resistant starch may differ between rice and pasta depending on amylose content and cooling protocol.

    “Second, the absolute and relative increase in resistant starch may differ between rice and pasta depending on amylose content and the cooling protocol; studies in non-diabetic populations confirm that both variety and preparation method influence resistant starch formation and glycemic response [24,25,27,28].”
    Quote in the paperNot a substantial claim2 of 4 sources checked
    • cites [24] Sonia, 2015, Effect of cooling of cooked white rice on resistant starch content and glycemic response, Asia Pac. J. Clin. Nutr. source
    • cites [25] Lu, L.W., Venn, B., Lu, J., Monro, J., and Rush, E. (2017). Effect of cold storage and reheating of parboiled rice on postprandial glycaemic response, satiety, palatability and chewed particle size distribution. Nutrients, 9. source

      The Discussion (page not provided) says resistant starch in rice may depend on heating–cooling cycles and amylose content. The paper does not compare resistant-starch increases in rice and pasta or establish their absolute or relative differences; pasta appears only in a reference title. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [27] Boers, 2015, A systematic review of the influence of rice characteristics and processing methods on postprandial glycaemic and insulinaemic responses, Br. J. Nutr. source

      The Discussion (Influence of the composition and processing of rice; page unavailable) says that higher amylose content after cooking and cooling leads to greater retrogradation, and the Abstract explains that retrograded amylose forms resistant starch. This supports the role of rice variety and preparation, but the paper does not compare rice with pasta or establish how their absolute or relative increases in resistant starch differ. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [28] Chiu, 2013, Effect of variety and cooking method on resistant starch content of white rice and subsequent postprandial glucose response and appetite in humans, Asia Pac. J. Clin. Nutr. source
  • Premisecitation

    Hodges et al. reported that serving a carbohydrate-rich meal containing pasta after chilling or reheating altered the postprandial glucose profile compared with serving the same meal hot.

    “Hodges et al. reported that serving a carbohydrate-rich meal containing pasta after chilling or reheating altered the postprandial glucose profile compared with serving the same meal hot, supporting the concept that household processing changes starch digestibility [14].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Hodges, C., Archer, F., Chowdhury, M., Evans, B.L., Ghelani, D.J., Mortoglou, M., and Guppy, F.M. (2020). Method of food preparation influences blood glucose response to a high-carbohydrate meal: A randomized cross-over trial. Foods, 9. source
  • Findingown data

    The number of hypoglycemic episodes did not differ between cooled/reheated pasta and fresh pasta conditions.

    “The number of hypoglycemic episodes did not differ between conditions.”
    • Also stated in: § 3.5. Hypoglycemic Episodes · plain
      “The number of postprandial hypoglycemic episodes within 180 min did not differ between conditions.”
    Quote in the paperSubstantial claim
  • May combine two claims. 20
  • Classified as probably not a substantial claim. 18
  • The quote only partly states this claim. 1

  • May combine two claims.

    Premisecitation

    Type 3 resistant starch forms when gelatinized starch is cooled, promoting retrogradation and increasing crystalline, enzyme-resistant structures of amylose and amylopectin.

    “Type 3 resistant starch (RS3) forms when gelatinized starch is cooled, a process that promotes retrogradation and increases crystalline, enzyme-resistant structures of amylose and amylopectin [8,9,10,11,12].”
    Quote in the paperSubstantial claim3 of 5 sources checked
    • cites [8] Sajilata, 2006, Resistant starch—A review, Compr. Rev. Food Sci. Food Saf. source
    • cites [9] Nugent, 2005, Health properties of resistant starch, Nutr. Bull. source

      The Classification and food sources section identifies RS3 as starch formed during retrogradation, and the Structure section says cooling gelatinized starch reforms crystals resistant to amylase hydrolysis. The latter section does not support the claim that both amylose and amylopectin form crystalline structures: it describes amylose as occupying amorphous regions and amylopectin as giving starch its crystalline structure. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [10] 2010, Resistant starch as functional ingredient: A review, Food Res. Int. source
    • cites [11] Patel, 2017, Structural and enzyme kinetic studies of retrograded starch: Inhibition of alpha-amylase and consequences for intestinal digestion of starch, Carbohydr. Polym. source
    • cites [12] Lovegrove, 2017, Role of polysaccharides in food, digestion, and health, Crit. Rev. Food Sci. Nutr. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Sustained near-normoglycemia is associated with fewer chronic complications and better quality of life in people with type 1 diabetes.

    “sustained near-normoglycemia is associated with fewer chronic complications and better quality of life [1,2,3].”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [1] International Diabetes Federation (2025). IDF Diabetes Atlas, IDF. [11th ed.].

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [2] Atkinson, 2014, Type 1 diabetes, Lancet source

      The Burden of type 1 diabetes section says achieving normoglycaemia is an important goal, especially for avoiding complications; its Complications subsection reports fewer cardiovascular and microvascular complications with intensive treatment. The Access to insulin subsection mentions technologies that improve quality of life, but does not establish that sustained near-normoglycaemia itself is associated with better quality of life. Page numbers are unavailable in our copy. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [3] American Diabetes Association Professional Practice Committee (2025). Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2025. Diabetes Care, 48, S128–S145. source

      The “Glucose Lowering and Microvascular Complications” section reports that better glycemic status in people with type 1 diabetes is associated with fewer microvascular complications, with benefits persisting during follow-up. The paper does not establish that sustained near-normoglycemia improves quality of life; its quality-of-life discussion instead concerns the adverse effects of hypoglycemia and the benefits of hypoglycemia-awareness training. Page numbers were not available in our copy. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    In people without diabetes, RS-enriched foods and household approaches such as cooling and reheating cooked starches are often associated with smaller postprandial glucose and insulin responses, although the magnitude depends on food matrix, amylose content, cooling duration, and number of heating-cooling cycles.

    “In people without diabetes, RS-enriched foods and household approaches such as cooling and reheating cooked starches are often associated with smaller postprandial glucose and insulin responses, although the magnitude of the effect depends on the food matrix, amylose content, cooling duration, and number of heating–cooling cycles [13,14,15,16].”
    Quote in the paperSubstantial claim3 of 4 sources checked
    • cites [13] Stewart, M.L., and Zimmer, J.P. (2017). A high fiber cookie made with resistant starch type 4 reduces postprandial glucose and insulin responses in healthy adults. Nutrients, 9. source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [14] Hodges, C., Archer, F., Chowdhury, M., Evans, B.L., Ghelani, D.J., Mortoglou, M., and Guppy, F.M. (2020). Method of food preparation influences blood glucose response to a high-carbohydrate meal: A randomized cross-over trial. Foods, 9. source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [15] Robertson, 2021, The cumulative effects of chilling and reheating a carbohydrate-based pasta meal on the postprandial glycaemic response: A pilot study, Eur. J. Clin. Nutr. source
    • cites [16] Stewart, M.L., Wilcox, M.L., Bell, M., Buggia, M.A., and Maki, K.C. (2018). Type-4 resistant starch reduces postprandial glycemic response and hunger in an acute randomized controlled study. Nutrients, 10. source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In a previous randomized crossover study of cooled rice in adults with T1D, cooling reduced postprandial glycemia but increased the frequency of hypoglycemia when insulin doses were not adjusted.

    “In our previous randomized crossover study of cooled rice in adults with T1D (FreeStyle Libre-based monitoring), cooling reduced postprandial glycemia but increased the frequency of hypoglycemia when insulin doses were not adjusted [17].”
    • Also stated in: § 4.3. Food-Matrix Specificity and Implications for Insulin Dosing in T1D · plain
      “In our prior crossover study of cooled rice in adults with T1D, cooling reduced postprandial glycemia but significantly increased hypoglycemic episodes during the 180 min observation period when insulin dosing was not adjusted [17].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [17] Strozyk, 2022, Influence of resistant starch resulting from the cooling of rice on postprandial glycemia in type 1 diabetes, Nutr. Diabetes source

  • May combine two claims.

    Premisecitation

    Analogous findings have been reported for rice and potatoes: cooling and/or reheating can increase resistant starch and lower postprandial glycemia in controlled studies, although the magnitude varies by food type and experimental design.

    “Analogous findings have been reported for rice and potatoes: cooling and/or reheating can increase resistant starch and lower postprandial glycemia in controlled studies, although the magnitude varies by food type and experimental design [24,25,26,27].”
    Quote in the paperNot a substantial claim3 of 4 sources checked
    • cites [24] Sonia, 2015, Effect of cooling of cooked white rice on resistant starch content and glycemic response, Asia Pac. J. Clin. Nutr. source
    • cites [25] Lu, L.W., Venn, B., Lu, J., Monro, J., and Rush, E. (2017). Effect of cold storage and reheating of parboiled rice on postprandial glycaemic response, satiety, palatability and chewed particle size distribution. Nutrients, 9. source

      The Introduction describes cooling and reheating as making rice starch more resistant to digestion, and Results §3.2 reports lower glycaemic response for reheated parboiled rice than for freshly cooked medium-grain white rice. But reheating did not significantly lower glycaemic response compared with freshly cooked parboiled rice; the paper does not report a measured increase in resistant starch from its treatment. This source addresses rice, not the sentence’s separate reference to potatoes. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [26] Patterson, M.A., Fong, J.N., Maiya, M., Kung, S., Sarkissian, A., Nashef, N., and Wang, W. (2019). Chilled potatoes decrease postprandial glucose, insulin, and glucose-dependent insulinotropic peptide compared to boiled potatoes in females with elevated fasting glucose and insulin. Nutrients, 11. source
    • cites [27] Boers, 2015, A systematic review of the influence of rice characteristics and processing methods on postprandial glycaemic and insulinaemic responses, Br. J. Nutr. source

  • May combine two claims.

    Premisecitation

    In experimental studies, appetite effects of resistant starch have been inconsistent and may depend on RS type, dose, and fermentation-related mechanisms rather than on the modest RS increase achieved by a single cooling cycle.

    “In experimental studies, appetite effects of resistant starch have been inconsistent and may depend on RS type, dose, and fermentation-related mechanisms rather than on the modest RS increase achieved by a single cooling cycle [16,29].”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [16] Stewart, M.L., Wilcox, M.L., Bell, M., Buggia, M.A., and Maki, K.C. (2018). Type-4 resistant starch reduces postprandial glycemic response and hunger in an acute randomized controlled study. Nutrients, 10. source

      The Discussion reports inconsistent acute satiety findings across studies of different RS4 types and doses: three earlier studies found no difference from controls, while this study found reduced hunger. It says the mechanism of that short-term effect is unclear. The Introduction discusses differences in fermentability, but the paper does not establish fermentation or dose as explanations for the appetite results, and it does not assess the modest RS increase from a single cooling cycle. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [29] Meng, 2017, Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations, Am. J. Clin. Nutr. source

      The Introduction and Study design and interventions sections describe how prior-meal composition affects subsequent glycemic responses, not appetite effects of resistant starch. Searches for resistant-starch appetite effects, RS type and dose, fermentation, and a cooling cycle found no passage addressing the claim; a References entry mentions fermentation only in relation to the second-meal glycemic effect. Page numbers were not available in our copy. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Carbohydrate appearance can be influenced by the composition of the preceding meal and by within-day factors.

    “Because carbohydrate appearance can also be influenced by the composition of the preceding meal and by within-day factors, consistent monitoring remains essential [6,29].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [6] Granfeldt, 2006, Determination of glycaemic index; some methodological aspects related to the analysis of carbohydrate load and characteristics of the previous evening meal, Eur. J. Clin. Nutr. source
    • cites [29] Meng, 2017, Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations, Am. J. Clin. Nutr. source

      The Results report that breakfast macronutrient composition changed the subsequent glucose response to white bread, and the Introduction discusses eating at different times of day. But the paper measures blood-glucose responses, not carbohydrate appearance, and does not independently test within-day factors. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • The quote only partly states this claim.

    Findingown data

    Resistant starch content increased after cooling and reheating pasta compared with fresh pasta (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g).

    “Resistant starch content increased after cooling (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g).”
    • Also stated in: § 3.2. Test Meal Composition and Resistant Starch · plain
      “Resistant starch content increased after cooling and reheating (Table 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Desire-to-eat ratings did not differ at any time point.

    “Desire-to-eat ratings did not differ at any time point.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Hunger ratings were slightly higher at 120 min after cooled/reheated pasta compared with fresh pasta.

    “Hunger ratings were slightly higher and satiety ratings slightly lower at 120 min after cooled/reheated pasta compared with fresh pasta; no significant differences were observed at the other time points.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Satiety ratings were slightly lower at 120 min after cooled/reheated pasta compared with fresh pasta.

    “Hunger ratings were slightly higher and satiety ratings slightly lower at 120 min after cooled/reheated pasta compared with fresh pasta; no significant differences were observed at the other time points.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Basal-rate stability between 13:00 and 17:00 was verified prior to study initiation, and basal rates were not changed on test days.

    “To minimize the influence of basal insulin infusion on the measured postprandial profile, each participant verified basal-rate stability between 13:00 and 17:00 prior to study initiation; if a non-optimal basal rate caused substantial glucose drift, basal settings were modified under medical supervision. On test days, basal rates were not changed.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The two test days were separated by at least 7 days and were scheduled at the same time of day for each participant.

    “The two test days were separated by at least 7 days and were scheduled at the same time of day for each participant.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Participants were blinded to the meal condition because the cooled pasta was reheated to match the serving temperature of the fresh pasta and was served with the same tomato sauce.

    “Participants were blinded to the meal condition because the cooled pasta was reheated to match the serving temperature of the fresh pasta and was served with the same tomato sauce.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Cooling and reheating pasta attenuates postprandial glycemia in adults with T1D without increasing early postprandial hypoglycemia in the studied setting.

    “Cooling and reheating pasta therefore increased RS and attenuated postprandial glycemia in adults with T1D without increasing early postprandial hypoglycemia in the studied setting.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Randomization was performed using a computer-generated sequence assigning participants in a 1:1 ratio to one of two meal-order sequences.

    “Randomization was performed using a computer-generated sequence that assigned participants in a 1:1 ratio to one of two meal-order sequences (fresh pasta followed by cooled/reheated pasta or cooled/reheated pasta followed by fresh pasta).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    No formal a priori sample size calculation was performed; the final sample size was determined pragmatically based on recruitment feasibility.

    “no formal a priori sample size calculation was performed. The final sample size was determined pragmatically based on recruitment feasibility and the number of eligible participants available during the study period.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The study tested only one pasta type and one cooling protocol.

    “we tested only one pasta type and one cooling protocol; resistant starch formation varies according to formulation, amylose content, cooling duration, and the number of heating–cooling cycles.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    No formal correction for multiple comparisons was applied.

    “Given the exploratory nature of the study, no formal correction for multiple comparisons was applied.”
    • Also stated in: § 4.6. Limitations · plain
      “no formal correction for multiple comparisons was applied; these issues should therefore be considered methodological limitations of this exploratory study.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Study design and conductreasoning

    The findings should be considered exploratory and hypothesis-generating.

    “Taken together, these limitations indicate that the findings should be considered exploratory and hypothesis-generating.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Resistant starch content increased by approximately 60% in cooled/reheated pasta, supporting a mechanistic link between RS formation and the observed reduction in glucose excursions.

    “In our study, resistant starch content increased by approximately 60% in cooled/reheated pasta, supporting a mechanistic link between RS formation and the observed reduction in glucose excursions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Breakfast composition and breakfast bolus dose were comparable on both test days.

    “Breakfast composition and breakfast bolus dose were comparable on both test days (Table 5).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Retrogradation-based strategies are not unique to a single starch source, but the food matrix strongly shapes the metabolic outcome.

    “These studies collectively suggest that retrogradation-based strategies are not unique to a single starch source but that the food matrix strongly shapes the metabolic outcome.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Interstitial glucose was assessed using flash glucose monitoring, which lags blood glucose during rapid glycemic change, so absolute peak glucose values and time-to-peak may have been affected.

    “Because interstitial glucose lags blood glucose during periods of rapid glycemic change, absolute peak glucose values and time-to-peak may have been affected.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was not prospectively registered in a public clinical trial registry.

    “The study was not prospectively registered in a public clinical trial registry.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Thirty-two participants completed both meal tests.

    “Thirty-two participants completed both meal tests.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    In the present pasta study, the same general approach improved glycemia without increasing early hypoglycemia under unchanged insulin doses.

    “In contrast, in the present pasta study, the same general approach improved glycemia without increasing early hypoglycemia under unchanged insulin doses.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    The observation period was limited to 180 min and did not capture later postprandial excursions, delayed hypoglycemia, time-in-range, time-above-range, or short-term glycemic variability.

    “the observation period was limited to 180 min and did not capture later postprandial excursions, delayed hypoglycemia, time-in-range, time-above-range, or short-term glycemic variability.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The meal matrix in this protocol (pasta with tomato sauce) may have modestly slowed absorption through viscosity and acidity, thereby buffering against rapid excursions and insulin-glucose mismatch.

    “Third, the meal matrix in this protocol (pasta with tomato sauce) may have modestly slowed absorption through viscosity and acidity, thereby buffering against rapid excursions and insulin–glucose mismatch.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Formal testing for period and carry-over effects was not performed.

    “Formal testing for period and carry-over effects was not performed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study was performed under standardized experimental meal conditions and may not fully reflect real-world eating patterns.

    “the study was performed under standardized experimental meal conditions and therefore may not fully reflect real-world eating patterns.”
    Quote in the paperNot a substantial claim
31 of 31

  • The paper relies on this without support.

    Whether cooling and reheating pasta improves postprandial glycemia in adults with T1D and alters early hypoglycemia risk under routine pump bolus-calculator dosing has not been established.

    “Whether cooling and reheating pasta further improves postprandial glycemia in adults with T1D—and whether this alters early hypoglycemia risk under routine pump bolus-calculator dosing—has not been established.”
1 of 1

Cites

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Authors
Rogowicz-Frontczak, A., Strozyk, S., Pilacinski, S., Koperska, A., Le Thanh-Blicharz, J., Tanska, M., & Zozulinska-Ziolkiewicz, D.
Affiliations
  • Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, 60-834 Poznan, Poland
  • Uniwersytet Pomorski w Słupsku (PL)
  • Poznan University of Medical Sciences (PL)
  • Department of Food Concentrates and Starch Products, Prof. Waclaw Dabrowski Institute of Agriculture and Food Biotechnology—State Research Institute, 02-532 Poznan, Poland
  • Institute of Health Sciences, Pomeranian University in Slupsk, 76-200 Slupsk, Poland
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2026-04-03
Volume
18
Issue
7
Pages
1152
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu18071152
PMC
PMC13074698
OpenAlex
W7150126403
Semantic Scholar
d122650806fde3bef41565fefb0e5448994a0afb
Cited by
1
References
24
Citations by year
2026: 1
FWCI
4.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by)
Funders
Abbott Diabetes Care
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
resistant starch, type 1 diabetes, postprandial glycemic response, pasta, starch retrogradation, insulin pump therapy, hypoglycemia, flash glucose monitoring, carbohydrate quality
MeSH terms
Resistant Starch, Continuous Glucose Monitoring, Adult, Blood Glucose, Cold Temperature, Cooking, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemia, Insulin, Insulin Infusion Systems, Male, Middle Aged, Starch, Single-Blind Method, Cross-Over Studies, Postprandial Period, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-17.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-17.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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