How does an additional insulin dose for a high-fat, high-protein breakfast affect glysemic response in adolescents with type 1 diabetes?

Objective: In this study, it was aimed to evaluate the effects of an additional insulin dose for high-fat and high-protein meal on blood glucose levels in adolescents with type 1 diabetes.Patients and Methods: This study was single-center, crossover, and randomized. Seven adolescents with type 1 diabetes between the ages of 14 and 17 were given breakfast containing high-fat (45.9% energy) and high-protein (21.9% energy) for two consecutive days, and two different insulin doses were administered. According to the first application dose of carbohydrate/insulin ratio, the second application was given this dose of additional insulin up to 30% in postprandial 180th minute. Blood glucose was monitored for 360 minutes at 30-minute intervals using a continuous glucose monitoring system (CGMS).Results: The average time spent in the target range (TIR) of participants was 30.6 +/- 11.83%, and time spent in hyperglycemia and hypoglycemia (time above range (TAR) and time below range (TBR)) were 67.0 +/- 14.31% and 2.4 +/- 4.89%, respectively. There was no statistically significant difference between the early (0-120th min), late (120-360th min), and total (0-360th min) glycemic responses of the applications (p>0.05). According to CGMS result, mean blood glucose, glycemic variability, and absolute blood glucose difference median and mean absolute deviation (MAD%) were found to be similar after two applications (p>0.05).Conclusion: Insulin dose applications should be individually calculated to prevent delayed-prolonged postprandial hyperglycemia caused by high-fat high - protein intake in adolescents with type 1 diabetes.