Prandial Insulin Dosing Strategies for High Glycemic Index Traditional Egyptian Meals in Pediatric and Adolescent Patients with Type 1 Diabetes on Insulin Pump Therapy

Abstract

ontinuous subcutaneous insulin infusion therapy (CSII) mimics physiological insulin delivery in patients with type 1 diabetes. Different nutritional macronutrients, including fat, protein and glycemic index of carbohydrates, significantly impact the postprandial glucose patterns among different patients with T1D. Insulin pumps are capable of offering different mealtime bolus regimens. Although Insulin pump offers different boluses to tailor insulin delivery according to meal composition; yet there are no previous studies to define the optimal bolus types with the optimal combination split percentage in the traditional Egyptian meals. The aim of the current study is to evaluate the efficacy of different prandial boluses delivery regimens on optimizing post prandial glycemia following consumption of different traditional Egyptian meals with high fat and protein content as well as meals with high glycemic index carbohydrates. Twenty-fourpatients with T1D were enrolled in this randomized controlled trial conducted at Pediatric and Adolescent Diabetes Unit (PADU) at Ain Shams University Hospitals.