Effectiveness of Carbohydrate Counting Method With Mixed Meals
Condition: Type 1 Diabetes
MeSH terms: Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      In a randomized, cross-over designed study, the investigators examined the effectiveness of
      the carbohydrate counting method after consumption of mixed meals typical of the Greek
      cuisine with various protein and fat contents in a sample of people with type 1 diabetes
      (DM1). The investigators also tried to further explore the effects of additional extra virgin
      olive oil (11 ml) on the glycemic response.
    

Detailed description: 
      A total of 20 adults with type 1 diabetes on intensive insulin therapy consumed three mixed
      meals at noon between 1200 and 1300 hours, with and without the addition of 11 ml extra
      virgin oil, in random order. One week before entering the study, participants kept a detailed
      7-day weighed food record with fingerprick blood glucose measurements pre-and-2hour
      post-meals for calculation of their carbohydrate (g) to insulin (units) ratio. Moreover, the
      individual correction factor was calculated. Thereafter, insulin requirements for the test
      meals were calculated based on the carbohydrate content of each dish and according to the
      personalised carbohydrate to insulin ratio. Postprandial glycemia was measured in capillary
      blood glucose samples at 30min intervals over 195min. For 24hr before each testing session,
      participants were asked to refrain from the consumption of alcohol and to maintain their
      usual physical activity pattern. On the day of testing, subjects were asked to consume their
      usual breakfast and abstain from food for at least 2 hours before their appointment. If blood
      glucose was >7.2 mmol/l at 1200, insulin was administered based on the individualised
      correction factor. If blood glucose was >10 mmol/l at the beginning of the testing session,
      insulin was administered to correct it and the subject was asked to return on another day. if
      hypoglycaemia occurred (defined as blood glucose level <3.8 mmol/l), the test session was
      stopped, the event was recorded and the patient treated appropriately. The on target 2hour
      postprandial blood glucose level was set between 3.9 and 10 mmol/l. Anthropometric
      measurements (body weight, waist and hip circumferences) were performed at every visit.
    

Intervention name(s): Mixed meal 1; Mixed meal 2; Mixed meal 3; Mixed meal 4; Mixed meal 5; Mixed meal 6
Intervention type(s): Other; Other; Other; Other; Other; Other
Intervention description(s): 20 adults with type 1 diabetes (T1DM) on intensive insulin treatment consumed a dish made with thick pasta, minced meat and béchamel sauce and 20 g kalamata olives. The meal provided 794 kcal and contained approximately 500 kcal from protein and fat. Insulin requirements for the test meal were calculated based on the carbohydrate content of the dish according to the personalised carbohydrate to insulin ratio.; 20 adults with type 1 diabetes (T1DM) on intensive insulin treatment consumed grilled chicken with vegetables.The meal provided 399 kcal and contained approximately 300 kcal from protein and fat. Insulin requirements for the test meal were calculated based on the carbohydrate content of the dish according to the personalised carbohydrate to insulin ratio.; 20 adults with type 1 diabetes (T1DM) on intensive insulin treatment consumed baked giant beans and 20g kalamata olives. The meal provided 502 kcal and contained approximately 300 kcal from protein and fat. Insulin requirements for the test meal were calculated based on the carbohydrate content of the dish according to the personalised carbohydrate to insulin ratio.; 20 adults with type 1 diabetes (T1DM) on intensive insulin treatment consumed a dish made with thick pasta, minced meat and béchamel sauce and 20 g kalamata olives and 11 ml extra virgin olive oil. The meal provided 893 kcal and contained approximately 600 kcal from protein and fat. Insulin requirements for the test meal were calculated based on the carbohydrate content of the dish according to the personalised carbohydrate to insulin ratio.; 20 adults with type 1 diabetes (T1DM) on intensive insulin treatment consumed grilled chicken with vegetables and 11 ml extra virgin olive oil. The meal provided 497 kcal and contained approximately 300 kcal from protein and fat. Insulin requirements for the test meal were calculated based on the carbohydrate content of the dish according to the personalised carbohydrate to insulin ratio.; 20 adults with type 1 diabetes (T1DM) on intensive insulin treatment consumed baked giant beans and 20 g kalamata olives and 11 ml extra virgin olive oil. The meal provided 601 kcal and contained approximately 400 kcal from protein and fat. Insulin requirements for the test meal were calculated based on the carbohydrate content of the dish according to the personalised carbohydrate to insulin ratio.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: carbohydrate counting method; protein; fat; glucose; type 1 diabetes