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Low‐fat vs. high‐fat bedtime snacks in children and adolescents with type 1 diabetes
Author(s) -
Wilson Darrell,
Chase H Peter,
Kollman Craig,
Xing Dongyuan,
Caswell Kimberly,
Tansey Michael,
Fox Larry,
Weinzimer Stuart,
Beck Roy,
Ruedy Katrina,
Tamborlane William
Publication year - 2008
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2008.00393.x
Subject(s) - medicine , evening , type 1 diabetes , hypoglycemia , carbohydrate , bedtime , insulin , endocrinology , calorie , type 2 diabetes , diabetes mellitus , food science , chemistry , physics , astronomy
Objective: The purpose of this study was to determine whether, in a group of children with type 1 diabetes using insulin pump, a prebedtime snack with a relatively high fat content provides greater protection from nocturnal hypoglycemia than a snack containing the same amount of carbohydrate and protein but a lower fat content. Research design and methods: Ten subjects, aged 6 to <18 yr, in a trial evaluating the Abbott Navigator glucose sensor, agreed to this ancillary study. On 12 or more separate nights, each subject was randomized by a Web site to a carbohydrate–low‐fat (30 g CHO, 2.5 g protein, and 1.3 g fat; 138 kcal) snack or a carbohydrate–high‐fat (30 g CHO, 2 g protein, and 20 g fat; 320 kcal) snack. Subjects used their usual evening snack algorithm to determine the size (in 15‐g carbohydrate increments) and insulin dosage. Results: Average glucose on 128 valid study nights before snack was similar in both groups. The proportion of nights with hypoglycemia (a sensor or meter glucose value ≤70 mg/dL) was similar in both groups (19% high fat vs. 20% low fat), as was the proportion of nights with hyperglycemia (a glucose ≥200 mg/dL and at least 50 mg/dL above baseline, 35% high fat vs. 30% low fat). Conclusions: There were no statistical differences between the high‐ and low‐fat snacks on the frequency of hyperglycemia or hypoglycemia. This study highlights the feasibility of web‐based research in patients’ home environment.