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Göteborgs universitets publikationer

Bedtime uncooked cornstarch supplement prevents nocturnal hypoglycaemia in intensively treated type 1 diabetes subjects.

Författare och institution:
Mette Axelsen (Institutionen för invärtesmedicin, Avdelningen för internmedicin); Christian Wesslau (Institutionen för invärtesmedicin, Avdelningen för internmedicin); Peter Lönnroth (Institutionen för invärtesmedicin, Avdelningen för internmedicin); Ragnhild Arvidsson Lenner (Institutionen för invärtesmedicin, Avdelningen för klinisk näringslära); Ulf Smith (Institutionen för invärtesmedicin, Avdelningen för internmedicin)
Publicerad i:
Journal of internal medicine, 245 ( 3 ) s. 229-36
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
OBJECTIVES: The present study tests two interrelated hypotheses: (1) that bedtime ingestion of uncooked cornstarch exerts a lower and delayed nocturnal blood glucose peak compared with a conventional snack; (2) that bedtime carbohydrate supplement, administered as uncooked cornstarch, prevents nocturnal hypoglycaemia without altering metabolic control in intensively treated type 1 diabetes (IDDM) patients. DESIGN AND SUBJECTS: The above hypotheses were tested separately (1) by pooling and analysing data from two overnight studies of comparable groups of patients with non-insulin dependent diabetes mellitus (NIDDM) (14 and 10 patients, respectively), and (2) by a double-blind, randomized 4-week cross-over study in 12 intensively treated IDDM patients. SETTING: Sahlgrenska University Hospital, Göteborg. Sweden. INTERVENTIONS: (1) Ingestion of uncooked cornstarch and wholemeal bread (0.6 g of carbohydrates kg-1 body weight) and carbohydrate-free placebo at 22.00 h. (2) Intake of uncooked cornstarch (0.3 g kg-1 body weight) and carbohydrate-free placebo at 23.00 h. MAIN OUTCOME MEASURES: (1) Nocturnal glucose and insulin levels; (2) frequency of self-estimated hypoglycaemia (blood glucose [BG] levels < 3.0 mmol L-1) at 03.00 h, HbA1c and fasting lipids. RESULTS: Bedtime uncooked cornstarch ingestion led to a lower (2.9 +/- 0.5 vs. 5.2 +/- 0.6 mM, P = 0.01) and delayed (4.3 +/- 0.6 vs. 2.0 +/- 0.0 h, P < 0.01) BG peak, compared with a conventional snack, in NIDDM patients. Four weeks of bedtime uncooked cornstarch supplement, as compared with placebo, led to a 70% reduction in the frequency of self-estimated hypoglycaemia at 03.00 h (P < 0.05), without affecting HbA1c or fasting lipids in IDDM patients. CONCLUSIONS: Uncooked cornstarch, ingested at bedtime, mimicked the nocturnal glucose utilization profile following insulin replacement, with a peak in blood glucose after 4 h. In IDDM patients, bedtime uncooked cornstarch supplement diminished the number of self-estimated hypoglycaemic episodes, without adversely affecting HbA1c and lipid levels. Hence, bedtime uncooked cornstarch ingestion may be feasible to prevent a mid-nocturnal glycaemic decline following insulin replacement in IDDM and, based on the nocturnal blood glucose profile, may also be preferable compared with conventional snacks.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Endokrinologi och diabetes ->
Hälsovetenskaper ->
Adult, Blood Glucose, metabolism, Cookery, Cross-Over Studies, Diabetes Mellitus, Type 1, blood, drug therapy, Double-Blind Method, Female, Hospitals, University, Humans, Hypoglycemia, blood, chemically induced, prevention & control, Hypoglycemic Agents, adverse effects, blood, Insulin, Long-Acting, adverse effects, blood, Male, Middle Aged, Starch, administration & dosage, Sweden, Time Factors, Treatment Outcome
Postens nummer:
Posten skapad:
2007-11-01 11:55
Posten ändrad:
2010-01-19 17:51

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