Post‐prandial glucose levels following three methods of insulin bolusing A study in adolescent girls and in comparison with girls without diabetes

Abstract

AbstractThe aims of this study were to assess whether one method of insulin bolusing was superior to two others in managing two pasta meals, and to compare the glucose levels with those of females without diabetes.Fifteen continuous subcutaneous insulin infusion (CSII)‐treated adolescent females and 10 adolescent females without diabetes consumed two pasta meals with different fat contents. The plasma glucose (p‐glucose) values were followed using capillary measurement and continuous glucose monitoring (CGMS) until three hours after the meal. The CSII‐treated females received the same insulin dose at every occasion as: (1) normal bolus; (2) dual‐wave bolus – 60% of the dose as normal bolus and 40% over one hour; and (3) square‐wave bolus – a prolonged dose over one hour.No differences were found in p‐glucose peak or AUC between the bolus methods after either of the meals. There was a difference in p‐glucose increase at one time point after the less fat meal; after 60 minutes the increase was greater with a square‐wave bolus (Friedman's test p <0.02). Forty‐eight percent of the measurements among the diabetes adolescents showed post‐prandial p‐glucose levels ≤ 10mmol/L. Females without diabetes had earlier and lower p‐glucose peak and smaller AUC.It was concluded that there were no overall differences in p‐glucose excursions between different methods of bolusing for these adolescent females after these meals. A square‐wave bolus may be less favourable with a less fatty pasta meal, giving a higher p‐glucose increase. It was possible to achieve normoglycaemic post‐prandial p‐glucose levels among adolescents with diabetes. Copyright © 2009 John Wiley & Sons.