Effect of Splitting Mealtime Insulin Doses After Mixed Meals High in Fat and Protein
Status:
Not yet recruiting
Trial end date:
2021-10-31
Target enrollment:
Participant gender:
Summary
The current management of type 1 diabetes mellitus (T1DM) depends on the use of intensive
insulin therapy - either by insulin pump therapy or multiple daily injection (MDI) therapy -
and the use of carbohydrate counting to determine the mealtime bolus insulin dose according
the carbohydrate contents of each meal or snack. However, several studies reported that the
fat and protein contents of the meals can also affect the postprandial blood glucose levels
and result in delayed postprandial hyperglycemia especially after high fat and protein meals.
There is no widely accepted regimen to calculate insulin required for the fat and protein
contents of meals especially for patients using multiple daily injection regimen. This study
aims to find a better method to cover the increased insulin requirements following mixed fat
and protein meals. The study will compare the effect of splitting mealtime bolus insulin
doses into pre-meal and post-meal portions to the standard regimen which involve giving bolus
dose depending on carbohydrate content only with additional correction doses 2 to 3 hours
after the meal to compensate for the postprandial hyperglycemia induced by fat and protein
content of the meals.