Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes

The optimal time to bolus insulin for meals is challenging for children and adolescents with type 1 diabetes (T1D). Current guidelines to control glucose excursions do not account for individual differences in glycaemic responses to meals. This study aimed to examine the within- and between-person v...

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Autores principales:	Emily Bell, Sabrina Binkowski, Elaine Sanderson, Barbara Keating, Grant Smith, Amelia J. Harray, Elizabeth A. Davis
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	type 1 diabetes paediatric diabetes glycaemic control CGM variability time to peak Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/ca81a238e757405999aa81e184deb852
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spelling	oai:doaj.org-article:ca81a238e757405999aa81e184deb8522021-11-25T18:37:11ZSubstantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes10.3390/nu131141542072-6643https://doaj.org/article/ca81a238e757405999aa81e184deb8522021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/4154https://doaj.org/toc/2072-6643The optimal time to bolus insulin for meals is challenging for children and adolescents with type 1 diabetes (T1D). Current guidelines to control glucose excursions do not account for individual differences in glycaemic responses to meals. This study aimed to examine the within- and between-person variability in time to peak (TTP) glycaemic responses after consuming meals under controlled and free-living conditions. Participants aged 8–15 years with T1D ≥ 1 year and using a continuous glucose monitor (CGM) were recruited. Participants consumed a standardised breakfast for six controlled days and maintained their usual daily routine for 14 free-living days. CGM traces were collected after eating. Linear mixed models were used to identify within- and between-person variability in the TTP after each of the controlled breakfasts, free-living breakfasts (FLB), and free-living dinners (FLD) conditions. Thirty participants completed the study (16 females; mean age and standard deviation (SD) 10.5 (1.9)). The TTP variability was greater within a person than the variability between people for all three meal types (between-person vs. within-person SD; controlled breakfast 18.5 vs. 38.9 min; FLB 14.1 vs. 49.6 min; FLD 5.7 vs. 64.5 min). For the first time, the study showed that within-person variability in TTP glycaemic responses is even greater than between-person variability.Emily BellSabrina BinkowskiElaine SandersonBarbara KeatingGrant SmithAmelia J. HarrayElizabeth A. DavisMDPI AGarticletype 1 diabetespaediatric diabetesglycaemic controlCGMvariabilitytime to peakNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 4154, p 4154 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 1 diabetes paediatric diabetes glycaemic control CGM variability time to peak Nutrition. Foods and food supply TX341-641
spellingShingle	type 1 diabetes paediatric diabetes glycaemic control CGM variability time to peak Nutrition. Foods and food supply TX341-641 Emily Bell Sabrina Binkowski Elaine Sanderson Barbara Keating Grant Smith Amelia J. Harray Elizabeth A. Davis Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes
description	The optimal time to bolus insulin for meals is challenging for children and adolescents with type 1 diabetes (T1D). Current guidelines to control glucose excursions do not account for individual differences in glycaemic responses to meals. This study aimed to examine the within- and between-person variability in time to peak (TTP) glycaemic responses after consuming meals under controlled and free-living conditions. Participants aged 8–15 years with T1D ≥ 1 year and using a continuous glucose monitor (CGM) were recruited. Participants consumed a standardised breakfast for six controlled days and maintained their usual daily routine for 14 free-living days. CGM traces were collected after eating. Linear mixed models were used to identify within- and between-person variability in the TTP after each of the controlled breakfasts, free-living breakfasts (FLB), and free-living dinners (FLD) conditions. Thirty participants completed the study (16 females; mean age and standard deviation (SD) 10.5 (1.9)). The TTP variability was greater within a person than the variability between people for all three meal types (between-person vs. within-person SD; controlled breakfast 18.5 vs. 38.9 min; FLB 14.1 vs. 49.6 min; FLD 5.7 vs. 64.5 min). For the first time, the study showed that within-person variability in TTP glycaemic responses is even greater than between-person variability.
format	article
author	Emily Bell Sabrina Binkowski Elaine Sanderson Barbara Keating Grant Smith Amelia J. Harray Elizabeth A. Davis
author_facet	Emily Bell Sabrina Binkowski Elaine Sanderson Barbara Keating Grant Smith Amelia J. Harray Elizabeth A. Davis
author_sort	Emily Bell
title	Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes
title_short	Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes
title_full	Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes
title_fullStr	Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes
title_full_unstemmed	Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes
title_sort	substantial intra-individual variability in post-prandial time to peak in controlled and free-living conditions in children with type 1 diabetes
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/ca81a238e757405999aa81e184deb852
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Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes

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