Tip 1 Diyabette Diyet Proteinlerinin ve Yağlarının Kan Glukozu Üzerine Etkilerinin Belirlenmesi
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The present study was conducted to determine the effects of dietary proteins and fats on blood glucose and the effects of fat-protein counting in addition to carbohydrate counting for calculating prandial insulin dosage on blood glucose profile in subjects with type 1 diabetes who are under multiple dose insulin treatment with 30 subjects with type 1 diabetes aged 16-18 years. All subjects were given 4 different breakfast meals being standardized meal (SM-insulin dose based on carbohydrate/insulin ratio), test meal with high protein (MHP-insulin dose based on carbohydrate/insulin ratio), test meal with high protein-high fat (MHPF-a-insulin dose based on carbohydrate/insulin ratio) and test meal with high proteinhigh fat (MHPF-b-insulin dose based on carbohydrate/insulin ratio and fat/protein ratio) on different days. On the 0., 30., 60., 90., 120., 150., 180., 210. and 240. minutes of meals consumption, capillary blood sample was taken and the effect of meals on blood glucose profile was examined. It was found that blood glucose levels of 0-90. minutes did not change after SM and test meals consumption (p>0.05), blood glucose levels were higher after MHPF-b consumption compared to MHPF-a consumption in measurements during 120-240. minutes (p<0.05). The effects of meals on postprandial glucose response showed that there was not a difference between meals in early (0-120. minutes) response (p=0.405). There was not a difference between SM, MHP and MHPF-a in late (120-240. minutes) response while response after MHPF-b was significantly lower than response after SM, MHP and MHPF-a consumption (p=0.032). Glycaemic index of meals showed that there was not a difference in relative glycaemic index on 0-120. minutes between meals while relative glycaemic index of MHPF-a on 120-240. minutes (118.92±44.62) was significantly higher than of SM (100.00±0.00) and MHPFb (95.03±39.01) and relative glycaemic index of MHPF-b was lower than MHP (109.77±37.42) (p=0.046). Similarly, relative glycaemic index of MHPF-a (110.47±25.95) on 0-240. minutes was found to be significantly higher than of SM (100.00±0.00) and MHPF-b (94.98±24.38) (p=0.046). It was observed that fat-protein counting caused a significant decrease in late glucose response compared to carbohydrate counting (p=0.032). It was concluded in the present study that arranging pre-meal insulin dosage considering fats and proteins and specific to meal composition has given positive results in post-meal glycaemic profile in subjects with Type 1 Diabetes who are under multiple dose insulin treatment.