BACKGROUND. Postprandial glycaemia is an important component of metabolic control in diabetics. The goal of this study was to evaluate the influence of fatprotein containing meal on glycaemia in type 1 diabetic patients treated with continous subcutaneous insulin infusion pump who were given square insulin bolus before meal.
MATERIAL AND METHODS. Thirtieth type 1 diabetic patients aged 18-50 years (26.3 ± 7.1), with the mean duration of the disease 12.3 ± 6.4 years, using continous subcutaneous insulin infusion pump were included in this study. All patients received the standardised meal containing 7 protein-fat exchanges and had blood glucose levels checked every 30 minutes during 8 hours period. Patients were randomized into 2 groups: 15 patients of the investigated group gave square insulin bolus (3.5 insulin units) before meal, 15 of the control group did not.
RESULTS. The glycaemia in the investigated group was significantly lower then in the control group in 180, 330, 420, 450 and 480 minute. The analysis of the glycaemia in both groups revealed statistically significant increase of blood glucose between 90 and 420 minute in the control group, but not in the investigated group (p < 0.05).
CONCLUSIONS. Protein and fat intake necessitates additional dose of insulin given as square bolus. The insulin dose for 1 protein-fat exchange should be lowered at least by half when compared with carbohydrate/insulin ratio. The duration of square insulin bolus given for 7 protein-fat exchanges should be shorter than 8 hours.
(Diabet. Prakt. 2010; 11, 1: 9-16)