Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content?
The aim of this review was to investigate existing guidelines and scientific evidence on determining insulin dosage in people with type 1 and type 2 diabetes, and in particular to check whether the prandial insulin dose should be calculated based on glycemia or the meal composition, including the ca...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-03-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | http://www.mdpi.com/2072-6643/11/3/607 |
| _version_ | 1811207463188299776 |
|---|---|
| author | Janusz Krzymien Piotr Ladyzynski |
| author_facet | Janusz Krzymien Piotr Ladyzynski |
| author_sort | Janusz Krzymien |
| collection | DOAJ |
| description | The aim of this review was to investigate existing guidelines and scientific evidence on determining insulin dosage in people with type 1 and type 2 diabetes, and in particular to check whether the prandial insulin dose should be calculated based on glycemia or the meal composition, including the carbohydrates, protein and fat content in a meal. By exploring the effect of the meal composition on postprandial glycemia we demonstrated that several factors may influence the increase in glycemia after the meal, which creates significant practical difficulties in determining the appropriate prandial insulin dose. Then we reviewed effects of the existing insulin therapy regimens on glycemic control. We demonstrated that in most existing algorithms aimed at calculating prandial insulin doses in type 1 diabetes only carbohydrates are counted, whereas in type 2 diabetes the meal content is often not taken into consideration. We conclude that prandial insulin doses in treatment of people with diabetes should take into account the pre-meal glycemia as well as the size and composition of meals. However, there are still open questions regarding the optimal way to adjust a prandial insulin dose to a meal and the possible benefits for people with type 1 and type 2 diabetes if particular parameters of the meal are taken into account while calculating the prandial insulin dose. The answers to these questions may vary depending on the type of diabetes. |
| first_indexed | 2024-04-12T04:04:40Z |
| format | Article |
| id | doaj.art-172dc8e1399b40aa9f1c3481e6bd4fb0 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-04-12T04:04:40Z |
| publishDate | 2019-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-172dc8e1399b40aa9f1c3481e6bd4fb02022-12-22T03:48:38ZengMDPI AGNutrients2072-66432019-03-0111360710.3390/nu11030607nu11030607Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content?Janusz Krzymien0Piotr Ladyzynski1Nalecz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences, 4 Trojdena Street, 02-109 Warsaw, PolandNalecz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences, 4 Trojdena Street, 02-109 Warsaw, PolandThe aim of this review was to investigate existing guidelines and scientific evidence on determining insulin dosage in people with type 1 and type 2 diabetes, and in particular to check whether the prandial insulin dose should be calculated based on glycemia or the meal composition, including the carbohydrates, protein and fat content in a meal. By exploring the effect of the meal composition on postprandial glycemia we demonstrated that several factors may influence the increase in glycemia after the meal, which creates significant practical difficulties in determining the appropriate prandial insulin dose. Then we reviewed effects of the existing insulin therapy regimens on glycemic control. We demonstrated that in most existing algorithms aimed at calculating prandial insulin doses in type 1 diabetes only carbohydrates are counted, whereas in type 2 diabetes the meal content is often not taken into consideration. We conclude that prandial insulin doses in treatment of people with diabetes should take into account the pre-meal glycemia as well as the size and composition of meals. However, there are still open questions regarding the optimal way to adjust a prandial insulin dose to a meal and the possible benefits for people with type 1 and type 2 diabetes if particular parameters of the meal are taken into account while calculating the prandial insulin dose. The answers to these questions may vary depending on the type of diabetes.http://www.mdpi.com/2072-6643/11/3/607carbohydrate countingprotein and fat countinginsulin dosageglucose monitoringdiabetes mellitustype 1 diabetestype 2 diabetes |
| spellingShingle | Janusz Krzymien Piotr Ladyzynski Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content? Nutrients carbohydrate counting protein and fat counting insulin dosage glucose monitoring diabetes mellitus type 1 diabetes type 2 diabetes |
| title | Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content? |
| title_full | Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content? |
| title_fullStr | Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content? |
| title_full_unstemmed | Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content? |
| title_short | Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content? |
| title_sort | insulin in type 1 and type 2 diabetes should the dose of insulin before a meal be based on glycemia or meal content |
| topic | carbohydrate counting protein and fat counting insulin dosage glucose monitoring diabetes mellitus type 1 diabetes type 2 diabetes |
| url | http://www.mdpi.com/2072-6643/11/3/607 |
| work_keys_str_mv | AT januszkrzymien insulinintype1andtype2diabetesshouldthedoseofinsulinbeforeamealbebasedonglycemiaormealcontent AT piotrladyzynski insulinintype1andtype2diabetesshouldthedoseofinsulinbeforeamealbebasedonglycemiaormealcontent |