Absorption patterns of meals containing complex carbohydrates in type 1 diabetes

D Elleri; J M Allen; J Harris; K Kumareswaran; M Nodale; L Leelarathna; C L Acerini; A Haidar; M E Wilinska; N Jackson; A M Umpleby; M L Evans; D B Dunger; R Hovorka

doi:10.1007/s00125-013-2852-x

Absorption patterns of meals containing complex carbohydrates in type 1 diabetes

D Elleri, J M Allen, J Harris, K Kumareswaran, M Nodale, L Leelarathna, C L Acerini, A Haidar, M E Wilinska, N Jackson, A M Umpleby, M L Evans, D B Dunger, R Hovorka

Research output: Contribution to journal › Article › peer-review

Abstract

AIMS/HYPOTHESIS: Successful postprandial glycaemia management requires understanding of absorption patterns after meals containing variable complex carbohydrates. We studied eight young participants with type 1 diabetes to investigate a large low-glycaemic-load (LG) meal and another eight participants to investigate a high-glycaemic-load (HG) meal matched for carbohydrates (121 g).

METHODS: On Visit 1, participants consumed an evening meal. On follow-up Visit 2, a variable-target glucose clamp was performed to reproduce glucose and insulin levels from Visit 1. Adopting stable-label tracer dilution methodology, we measured endogenous glucose production on Visit 2 and subtracted it from total glucose appearance measured on Visit 1 to obtain meal-attributable glucose appearance.

RESULTS: After the LG meal, 25%, 50% and 75% of cumulative glucose appearance was at 88 ± 21, 175 ± 39 and 270 ± 54 min (mean ± SD), whereas glucose from the HG meal appeared significantly faster at 56 ± 12, 100 ± 25 and 153 ± 39 min (p < 0.001 to 0.003), and resulted in a 50% higher peak appearance (p < 0.001). Higher apparent bioavailability by 15% (p = 0.037) was observed after the LG meal. We documented a 20 min deceleration of dietary mixed carbohydrates compared with dietary glucose for the HG meal and a twofold deceleration for the LG meal.

CONCLUSIONS/INTERPRETATION: Absorption patterns may be influenced by glycaemic load and/or meal composition, affecting optimum prandial insulin dosing in type 1 diabetes.

Original language	English
Pages (from-to)	1108-1117
Number of pages	10
Journal	Diabetologia
Volume	56
Issue number	5
DOIs	https://doi.org/10.1007/s00125-013-2852-x
Publication status	Published - May 2013

Keywords

Adolescent
Adult
Blood Glucose/analysis
Diabetes Mellitus, Type 1/blood
Dietary Carbohydrates/adverse effects
Female
Gluconeogenesis
Glucose Clamp Technique
Glycemic Index
Humans
Hyperglycemia/etiology
Hypoglycemic Agents/blood
Indicator Dilution Techniques
Insulin/blood
Intestinal Absorption
Male
Meals
Models, Biological
Postprandial Period
Young Adult

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00125-013-2852-x

Cite this

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title = "Absorption patterns of meals containing complex carbohydrates in type 1 diabetes",

abstract = "AIMS/HYPOTHESIS: Successful postprandial glycaemia management requires understanding of absorption patterns after meals containing variable complex carbohydrates. We studied eight young participants with type 1 diabetes to investigate a large low-glycaemic-load (LG) meal and another eight participants to investigate a high-glycaemic-load (HG) meal matched for carbohydrates (121 g).METHODS: On Visit 1, participants consumed an evening meal. On follow-up Visit 2, a variable-target glucose clamp was performed to reproduce glucose and insulin levels from Visit 1. Adopting stable-label tracer dilution methodology, we measured endogenous glucose production on Visit 2 and subtracted it from total glucose appearance measured on Visit 1 to obtain meal-attributable glucose appearance.RESULTS: After the LG meal, 25%, 50% and 75% of cumulative glucose appearance was at 88 ± 21, 175 ± 39 and 270 ± 54 min (mean ± SD), whereas glucose from the HG meal appeared significantly faster at 56 ± 12, 100 ± 25 and 153 ± 39 min (p < 0.001 to 0.003), and resulted in a 50% higher peak appearance (p < 0.001). Higher apparent bioavailability by 15% (p = 0.037) was observed after the LG meal. We documented a 20 min deceleration of dietary mixed carbohydrates compared with dietary glucose for the HG meal and a twofold deceleration for the LG meal.CONCLUSIONS/INTERPRETATION: Absorption patterns may be influenced by glycaemic load and/or meal composition, affecting optimum prandial insulin dosing in type 1 diabetes.",

keywords = "Adolescent, Adult, Blood Glucose/analysis, Diabetes Mellitus, Type 1/blood, Dietary Carbohydrates/adverse effects, Female, Gluconeogenesis, Glucose Clamp Technique, Glycemic Index, Humans, Hyperglycemia/etiology, Hypoglycemic Agents/blood, Indicator Dilution Techniques, Insulin/blood, Intestinal Absorption, Male, Meals, Models, Biological, Postprandial Period, Young Adult",

author = "D Elleri and Allen, {J M} and J Harris and K Kumareswaran and M Nodale and L Leelarathna and Acerini, {C L} and A Haidar and Wilinska, {M E} and N Jackson and Umpleby, {A M} and Evans, {M L} and Dunger, {D B} and R Hovorka",

year = "2013",

month = may,

doi = "10.1007/s00125-013-2852-x",

language = "English",

volume = "56",

pages = "1108--1117",

journal = "Diabetologia",

issn = "0012-186X",

publisher = "Springer Nature",

number = "5",

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TY - JOUR

T1 - Absorption patterns of meals containing complex carbohydrates in type 1 diabetes

AU - Elleri, D

AU - Allen, J M

AU - Harris, J

AU - Kumareswaran, K

AU - Nodale, M

AU - Leelarathna, L

AU - Acerini, C L

AU - Haidar, A

AU - Wilinska, M E

AU - Jackson, N

AU - Umpleby, A M

AU - Evans, M L

AU - Dunger, D B

AU - Hovorka, R

PY - 2013/5

Y1 - 2013/5

N2 - AIMS/HYPOTHESIS: Successful postprandial glycaemia management requires understanding of absorption patterns after meals containing variable complex carbohydrates. We studied eight young participants with type 1 diabetes to investigate a large low-glycaemic-load (LG) meal and another eight participants to investigate a high-glycaemic-load (HG) meal matched for carbohydrates (121 g).METHODS: On Visit 1, participants consumed an evening meal. On follow-up Visit 2, a variable-target glucose clamp was performed to reproduce glucose and insulin levels from Visit 1. Adopting stable-label tracer dilution methodology, we measured endogenous glucose production on Visit 2 and subtracted it from total glucose appearance measured on Visit 1 to obtain meal-attributable glucose appearance.RESULTS: After the LG meal, 25%, 50% and 75% of cumulative glucose appearance was at 88 ± 21, 175 ± 39 and 270 ± 54 min (mean ± SD), whereas glucose from the HG meal appeared significantly faster at 56 ± 12, 100 ± 25 and 153 ± 39 min (p < 0.001 to 0.003), and resulted in a 50% higher peak appearance (p < 0.001). Higher apparent bioavailability by 15% (p = 0.037) was observed after the LG meal. We documented a 20 min deceleration of dietary mixed carbohydrates compared with dietary glucose for the HG meal and a twofold deceleration for the LG meal.CONCLUSIONS/INTERPRETATION: Absorption patterns may be influenced by glycaemic load and/or meal composition, affecting optimum prandial insulin dosing in type 1 diabetes.

AB - AIMS/HYPOTHESIS: Successful postprandial glycaemia management requires understanding of absorption patterns after meals containing variable complex carbohydrates. We studied eight young participants with type 1 diabetes to investigate a large low-glycaemic-load (LG) meal and another eight participants to investigate a high-glycaemic-load (HG) meal matched for carbohydrates (121 g).METHODS: On Visit 1, participants consumed an evening meal. On follow-up Visit 2, a variable-target glucose clamp was performed to reproduce glucose and insulin levels from Visit 1. Adopting stable-label tracer dilution methodology, we measured endogenous glucose production on Visit 2 and subtracted it from total glucose appearance measured on Visit 1 to obtain meal-attributable glucose appearance.RESULTS: After the LG meal, 25%, 50% and 75% of cumulative glucose appearance was at 88 ± 21, 175 ± 39 and 270 ± 54 min (mean ± SD), whereas glucose from the HG meal appeared significantly faster at 56 ± 12, 100 ± 25 and 153 ± 39 min (p < 0.001 to 0.003), and resulted in a 50% higher peak appearance (p < 0.001). Higher apparent bioavailability by 15% (p = 0.037) was observed after the LG meal. We documented a 20 min deceleration of dietary mixed carbohydrates compared with dietary glucose for the HG meal and a twofold deceleration for the LG meal.CONCLUSIONS/INTERPRETATION: Absorption patterns may be influenced by glycaemic load and/or meal composition, affecting optimum prandial insulin dosing in type 1 diabetes.

KW - Adolescent

KW - Adult

KW - Blood Glucose/analysis

KW - Diabetes Mellitus, Type 1/blood

KW - Dietary Carbohydrates/adverse effects

KW - Female

KW - Gluconeogenesis

KW - Glucose Clamp Technique

KW - Glycemic Index

KW - Humans

KW - Hyperglycemia/etiology

KW - Hypoglycemic Agents/blood

KW - Indicator Dilution Techniques

KW - Insulin/blood

KW - Intestinal Absorption

KW - Male

KW - Meals

KW - Models, Biological

KW - Postprandial Period

KW - Young Adult

U2 - 10.1007/s00125-013-2852-x

DO - 10.1007/s00125-013-2852-x

M3 - Article

C2 - 23435829

SN - 0012-186X

VL - 56

SP - 1108

EP - 1117

JO - Diabetologia

JF - Diabetologia

IS - 5

ER -

Absorption patterns of meals containing complex carbohydrates in type 1 diabetes

Abstract

Keywords

UN SDGs

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