The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial
Abstract Background The optimization of glucose control in type-1 diabetes is challenged by postprandial glycemic variability. This study aimed to compare the postprandial glycemic effects of carbohydrate counting and the modified fat-protein unit (FPU) algorithms following meals with different prot...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Nutrition & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12986-023-00757-w |
| _version_ | 1797453652794802176 |
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| author | Yunying Cai Mengge Li Lun Zhang Jie Zhang Heng Su |
| author_facet | Yunying Cai Mengge Li Lun Zhang Jie Zhang Heng Su |
| author_sort | Yunying Cai |
| collection | DOAJ |
| description | Abstract Background The optimization of glucose control in type-1 diabetes is challenged by postprandial glycemic variability. This study aimed to compare the postprandial glycemic effects of carbohydrate counting and the modified fat-protein unit (FPU) algorithms following meals with different protein and fat emphases in adults with type-1 diabetes. Methods Thirty adults with type-1 diabetes aged 18 to 45 years participated in a randomized crossover trial. In a random order, participants consumed four test meals with equivalent energy and different macronutrient emphases on four separate mornings. The modified FPU algorithms and carbohydrate counting were used to determine the insulin dose for the test meals. A continuous glucose monitoring system was used to measured postprandial glycemia. Results Compared with carbohydrate counting, the modified FPU algorithm significantly decreased the late postprandial mean glucose levels (p = 0.026) in high protein-fat meals. The number of hypoglycemia episodes was similar between insulin dosing algorithms for the high protein-fat meals; hypoglycemic events were considerably higher for the modified FPU in the normal protein-fat meal (p = 0.042). Conclusions The modified FPU algorithm may improve postprandial glycemic control after consuming high protein-fat meals in adults with type-1 diabetes but may result in increased hypoglycemia risk when used with a normal protein-fat meal. |
| first_indexed | 2024-03-09T15:25:56Z |
| format | Article |
| id | doaj.art-084ec380a7c14454ba5d831077bc0102 |
| institution | Directory Open Access Journal |
| issn | 1743-7075 |
| language | English |
| last_indexed | 2024-03-09T15:25:56Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition & Metabolism |
| spelling | doaj.art-084ec380a7c14454ba5d831077bc01022023-11-26T12:32:16ZengBMCNutrition & Metabolism1743-70752023-10-012011710.1186/s12986-023-00757-wThe effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trialYunying Cai0Mengge Li1Lun Zhang2Jie Zhang3Heng Su4The Endocrinology Department, First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and TechnologyWenjiang District People’s Hospital of ChengduThe Clinical Nutrition Department, First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and TechnologyThe Endocrinology Department, First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and TechnologyThe Endocrinology Department, First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and TechnologyAbstract Background The optimization of glucose control in type-1 diabetes is challenged by postprandial glycemic variability. This study aimed to compare the postprandial glycemic effects of carbohydrate counting and the modified fat-protein unit (FPU) algorithms following meals with different protein and fat emphases in adults with type-1 diabetes. Methods Thirty adults with type-1 diabetes aged 18 to 45 years participated in a randomized crossover trial. In a random order, participants consumed four test meals with equivalent energy and different macronutrient emphases on four separate mornings. The modified FPU algorithms and carbohydrate counting were used to determine the insulin dose for the test meals. A continuous glucose monitoring system was used to measured postprandial glycemia. Results Compared with carbohydrate counting, the modified FPU algorithm significantly decreased the late postprandial mean glucose levels (p = 0.026) in high protein-fat meals. The number of hypoglycemia episodes was similar between insulin dosing algorithms for the high protein-fat meals; hypoglycemic events were considerably higher for the modified FPU in the normal protein-fat meal (p = 0.042). Conclusions The modified FPU algorithm may improve postprandial glycemic control after consuming high protein-fat meals in adults with type-1 diabetes but may result in increased hypoglycemia risk when used with a normal protein-fat meal.https://doi.org/10.1186/s12986-023-00757-wCarbohydrate countingModified fat-protein unit algorithmHigh protein-fat mealType − 1 diabetes |
| spellingShingle | Yunying Cai Mengge Li Lun Zhang Jie Zhang Heng Su The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial Nutrition & Metabolism Carbohydrate counting Modified fat-protein unit algorithm High protein-fat meal Type − 1 diabetes |
| title | The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial |
| title_full | The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial |
| title_fullStr | The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial |
| title_full_unstemmed | The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial |
| title_short | The effect of the modified fat-protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type-1 diabetes when consuming meals with differing macronutrient compositions: a randomized crossover trial |
| title_sort | effect of the modified fat protein unit algorithm compared with that of carbohydrate counting on postprandial glucose in adults with type 1 diabetes when consuming meals with differing macronutrient compositions a randomized crossover trial |
| topic | Carbohydrate counting Modified fat-protein unit algorithm High protein-fat meal Type − 1 diabetes |
| url | https://doi.org/10.1186/s12986-023-00757-w |
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