Purpose

Oxidative stress is closely related to type 1 diabetes mellitus (T1DM), playing a key role in the pathogenesis of the disease and progression of complications. It is characterized by loss of equilibrium between oxidative factors and antioxidant protective mechanisms. Several markers have been used to assess both components of oxidative status; two of which are malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP).

Methods

We investigated glycated hemoglobin (HbA1c), lipid profile, MDA, and FRAP in 35 patients with T1DM, aged 2–23 years, at the end of two 4-month observational periods: period A: standard insulin dosing per meal, and period B: proper prandial insulin dosing based on the amount of carbohydrates contained in each meal.

Results

At the end of period B, (i) glucose control (HbA1c) was improved; (ii) oxidative stress, estimated by MDA, showed a tendency to decrease; and (iii) antioxidant capacity, estimated by FRAP, was significantly increased compared with that of period A. No significant differences were observed in the lipid profile of the patients between the two periods.

Conclusion

Proper insulin dosing based on carbohydrate counting (CC) may have an impact on the antioxidant defensive mechanisms of patients with T1DM through the attainment of a better glycemic profile. There are also indications that it may reduce MDA, an important biomarker of oxidative stress and a significant mediator of complications in T1DM. Therefore, prompt dietetic intervention using CC as early as possible after the diagnosis of T1DM is important for achieving optimal glycemic control and improved oxidative status.

中文翻译：

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碳水化合物计数在1型糖尿病（T1DM）患者的血糖控制和氧化应激中的作用。

目的

氧化应激与1型糖尿病（T1DM）密切相关，在疾病的发病机理和并发症的进展中起着关键作用。其特征是氧化因子和抗氧化剂保护机制之间失去平衡。几种标记已被用于评估氧化状态的两个组成部分。其中两个是丙二醛（MDA）和铁还原抗氧化能力（FRAP）。

方法

我们在两个4个月的观察期结束时调查了2-23岁的35例T1DM患者的糖化血红蛋白（HbA1c），脂质分布，MDA和FRAP，这是两个四个月的观察期结束：A期：每餐标准胰岛素剂量，B期：根据每餐中所含碳水化合物的量，适当饮食中的胰岛素剂量。

结果

在B期末，（i）血糖控制（HbA1c）得到改善；（ii）由MDA估算的氧化应激表现出降低的趋势；（iii）通过FRAP评估的抗氧化能力与A期相比显着提高。在这两个时期之间，患者的脂质分布没有观察到显着差异。

结论

基于碳水化合物计数（CC）的正确胰岛素剂量可能会通过获得更好的血糖水平而对T1DM患者的抗氧化防御机制产生影响。也有迹象表明它可能降低MDA，MDA是氧化应激的重要生物标志物，也是T1DM并发症的重要介质。因此，在T1DM诊断后尽早使用CC进行及时的饮食干预对于实现最佳的血糖控制和改善氧化状态非常重要。