Aims: Intensive insulin therapy (IIT) is the preferred treatment for patients with type 1 diabetes, which requires them to calculate the total number of grams of carbohydrate eaten, but little research has been performed on the effect of mixed meals on blood sugar. We examined the effects of popular takeaway foods on glycaemic response in people with type 1 diabetes.
Methods: Nine participants on IIT each consumed a pasta, Thai, hamburger and sandwich (cheese sandwich and an apple) meal on four different occasions, at least 3 days apart. The meals had the same amount of carbohydrate but different macronutrient quantities and different glycaemic indices (GI). Participants' normal basal insulin was given, but the mealtime bolus insulin was withheld to measure blood glucose level (BGL), every half hour for 3 h postprandially.
Results: The glycaemic response as measured by 2-h BGL, the area under the BGL curve and BGL range (maximum-minimum over 3 h) were consistently lower after ingesting a low-GI high-fat pasta meal in relation to the other meals. There was no difference between the sandwich, Thai and hamburger meals. BGLs rose between 3.91 and 8.44 mmol/l at the conclusion of 3 h, which shows that a single CHO portion (15 g) can raise BGLs by 1-2 mmol/l, depending on the GI of the food.
Conclusions: People with type 1 diabetes on IIT who are concerned about postprandial glycaemic variability should consider not only overall carbohydrate content but also glycaemic index and fat content when adjusting insulin dosages.