Effect of nutrition on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully automated closed-loop insulin therapy.

Banholzer, Nicolas; Herzig, David; Piazza, Camillo; Álvarez-Martínez, Mario; Nakas, Christos T; Kosinski, Christophe; Feuerriegel, Stefan; Hovorka, Roman; Bally, Lia (2021). Effect of nutrition on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully automated closed-loop insulin therapy. Diabetes, obesity & metabolism, 23(1), pp. 234-239. Wiley 10.1111/dom.14187

[img]
Preview
Text
Effect on nutrition on postprandial.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (739kB) | Preview

Fully automated closed-loop insulin delivery may offer a novel way to manage diabetes in hospital. However, postprandial glycaemic control remains challenging. We aimed to assess the effect of nutritional intake on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully closed-loop insulin therapy. The effects of different meal types and macronutrient composition on sensor glucose time-in-target (TIT, 3.9-10.0 mmol/L) and mean sensor glucose were assessed with hierarchical linear models using a Bayesian estimation approach. TIT was lower and the mean sensor glucose slightly higher, after breakfast compared with lunch and dinner, whereas the insulin dose was higher. Across meals, when carbohydrates were replaced by fat, or to a lesser extent by protein, postprandial glucose control improved. For breakfast, a 3.9% improvement in TIT was observed when 10% of the energy from carbohydrates was replaced by fat. Improvements were slightly lower during lunch and dinner (3.2% and 3.4%) or when carbohydrates were replaced by protein (2.2 and 2.7%, respectively). We suggest that reducing carbohydrate at the expense of fat or protein, could further improve glucose control during fully closed-loop insulin therapy in hospital.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry

UniBE Contributor:

Herzig, David; Nakas, Christos T.; Kosinski, Christophe and Bally, Lia Claudia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1463-1326

Publisher:

Wiley

Language:

English

Submitter:

Karin Balmer

Date Deposited:

09 Nov 2020 14:03

Last Modified:

11 Mar 2021 23:29

Publisher DOI:

10.1111/dom.14187

PubMed ID:

32885596

Uncontrolled Keywords:

glycaemic control insulin therapy type 2 diabetes

BORIS DOI:

10.7892/boris.147796

URI:

https://boris.unibe.ch/id/eprint/147796

Actions (login required)

Edit item Edit item
Provide Feedback