Objective This randomized cross-over study aimed to compare different algorithms for calculating prandial insulin considering the fat and protein content of a standardized meal in type 1 diabetes patients using insulin pump therapy (CSII). Methods Twenty-six patients received a standardized evening meal for three consecutive days using different algorithms for insulin dose adjustment: A) exclusive consideration of carbohydrate content without considering fat-protein content, B) high-dose algorithm considering additional insulin for fat protein units (FPUs) with the same factor as for carbohydrates, and C) low-dose algorithm considering additional insulin for FPUs with half the factor as for carbohydrates. The primary outcome was the proportion of interstitial glucose values in the target range (≥ 70 to ≤ 180 mg/dl) during the post-prandial 12-hour follow-up period. Secondary outcomes were the occurrence of hypo- and hyperglycemic episodes and the coverage with carbohydrates for treatment of hypoglycemia. Results The percentage of glucose values in the target range was significantly higher when fat-protein content was not considered, whereas, in the hyperglycemic range, it did not differ significantly among the three groups. The percentage of hypoglycemic glucose values were the highest in the groups considering fat-protein content and lowest in the group not considering FPUs with no significant difference between the two groups in terms of FPUs. Conclusions In adult type 1 diabetes patients using CSII, it is not recommended to consider a high fat and protein content in the diet when calculating prandial insulin dosage with the selected algorithms, as this increases the risk of hypoglycemia disproportionately.

中文翻译：

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餐后胰岛素应用于脂肪蛋白单位对胰岛素泵治疗 1 型糖尿病患者餐后血糖波动的影响：随机、对照、交叉研究的结果

目的 本随机交叉研究旨在比较使用胰岛素泵治疗 (CSII) 的 1 型糖尿病患者标准化膳食的脂肪和蛋白质含量计算餐时胰岛素的不同算法。方法 26 名患者连续三天接受标准化晚餐，使用不同的胰岛素剂量调整算法：A）仅考虑碳水化合物含量而不考虑脂肪蛋白含量，B）考虑脂肪蛋白单位额外胰岛素的高剂量算法（ FPUs) 具有与碳水化合物相同的因子，以及 C) 低剂量算法考虑 FPUs 的额外胰岛素，其因子为碳水化合物的一半。主要结果是餐后 12 小时随访期间间质葡萄糖值在目标范围内（≥ 70 至 ≤ 180 mg/dl）的比例。次要结局是低血糖和高血糖发作的发生率以及碳水化合物治疗低血糖的覆盖率。结果在不考虑脂肪-蛋白质含量的情况下，目标范围内的葡萄糖值百分比显着升高，而在高血糖范围内，三组之间没有显着差异。低血糖值百分比在考虑脂肪蛋白含量的组中最高，在不考虑 FPU 的组中最低，两组之间在 FPU 方面没有显着差异。结论 在使用 CSII 的成人 1 型糖尿病患者中，