Campbell, MD, Walker, M, Ajjan, RA et al. (3 more authors) (2017) An additional bolus of rapid-acting insulin to normalise postprandial cardiovascular risk factors following a high-carbohydrate high-fat meal in patients with type 1 diabetes: A randomised controlled trial. Diabetes and Vascular Disease Research, 14 (4). pp. 336-344. ISSN 1479-1641
Abstract
Aim: To evaluate an additional rapid-acting insulin bolus on postprandial lipaemia, inflammation, and pro-coagulation following high-carbohydrate high-fat feeding in people with type 1 diabetes. Methods: Ten males with type 1 diabetes (HbA1c 52.5±5.9 mmol/mol [7.0±0.5%]) underwent three conditions: 1) a low-fat meal with normal bolus insulin (LF), 2), a high-fat meal with normal bolus insulin (HF), 3) a high-fat meal with normal bolus insulin with an additional 30% insulin bolus administered 3-hrs post-meal (HFA). Meals had identical carbohydrate and protein content and bolus insulin dose determined by carbohydrate-counting. Blood was sampled periodically for 6-hr post-meal and analysed for TG, NEFA, APOB48, glucagon, TNF-α, fibrinogen, HTF activity, and PAI-1. Continuous glucose monitoring captured interstitial glucose responses. Results: TG concentrations following LF remained similar to baseline, whereas TG levels following HF were significantly greater throughout the 6-hour observation period. The additional insulin bolus (HFA) normalised TG similarly to LF 3-6-hrs following the meal. HF was associated with late postprandial elevations in TNF-α, whereas LF and HFA was not. Fibrinogen, PAI-1, and TFP levels were similar between conditions. Conclusions: Additional bolus insulin 3-hrs following a high-carbohydrate high-fat meal prevents late rises in postprandial TGs and TNF-α, thus improving cardiovascular risk profile.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2017. This is an author produced version of a paper accepted for publication in Diabetes and Vascular Disease Research. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Type 1 diabetes; high-fat feeding; lipaemia; inflammation; cardiovascular risk |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Biomedical Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Feb 2017 11:41 |
Last Modified: | 16 Jan 2018 05:43 |
Published Version: | https://doi.org/10.1177/1479164117698918 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/1479164117698918 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:112573 |