Best Timing of Insulin Bolus Before Meals of Different Contents

The Effect of Food Content and Optimal Timing of Pre-meal Insulin Bolus on the Postprandial Glycemic Control in Children With Type 1 Diabetes

Post-meal glucose excursions may contribute to the development of diabetes-related complications. These glucose excursions are affected by the food content of the meal and the timing of insulin injection (or insulin pump-bolus) before meal. The best timing for insulin bolus (by pump) is controversial.

The aim of the study is to examine three different timings of insulin bolus in three types of breakfast meals that contain carbohydrates, carbohydrates + proteins and carbohydrate+ fat. The 3h post-meal glucose excursions will be recorded by continuous glucose monitoring system. The results obtained in the diabetic patients will be compared to those obtained in a group of healthy individuals that will consume similar meals.

Inclusion Criteria:

Diabetes patients:

• Type 1 diabetes
• Age 8 to 20 years
• Both genders

Control group:

• Age 18 to 30 years
• Both genders

Exclusion Criteria:

Diabetes patients:

• Less than a year from the diagnosis of type 1 diabetes
• Less than 6 months from the time of insulin pump introduction

Control group:

• Pregnancy
• Any diagnosed or suspected chronic diseases
• Current or recent (within 1 month) use of drugs (not including oral contraceptives and inhaled steroids for asthma).