The effect of snack size carbohydrate quantities on blood glucose

  • Research type

    Research Study

  • Full title

    Busting the myth of an ‘insulin-free’ snack: investigating the effect of snack size carbohydrate quantities on postprandial glycaemic control in children with type 1 diabetes.

  • IRAS ID

    270467

  • Contact name

    Astha Soni

  • Contact email

    a.soni1@nhs.net

  • Sponsor organisation

    Sheffield Children's NHS Foundation Trust

  • Clinicaltrials.gov Identifier

    N/A, N/A

  • Duration of Study in the UK

    0 years, 9 months, 4 days

  • Research summary

    Based on mimicking normal physiology, the foundations of type 1 diabetes management are based on the effects of carbohydrate on blood glucose levels. Carbohydrates are the key macronutrient influencing glycaemia due to their direct catabolism into glucose. Children with Type 1 diabetes lack the ability to regulate the body’s blood glucose levels due to an absolute insulin deficiency. They are therefore subject to lifelong treatment with insulin, with the majority of patients using intensive insulin therapy either through multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Insulin is delivered at a basal rate in addition to pre-prandial boluses calculated according to a patient’s insulin: carbohydrate ratio. With the introduction of continuous glucose monitoring (CGM), a new emphasis has been placed on postprandial glycaemic control. There is increasing evidence emerging indicating that postprandial hyperglycaemia has a strong influence on an individual’s HbA1c and thus micro- and macrovascular complications. A wealth of research has been undertaken assessing the relationship between carbohydrates, their postprandial effects and thus optimal insulin dosage. However, there is yet to be any investigation into how small quantities of carbohydrate impact blood glucose levels. Despite this, education programmes promoting carbohydrate counting in the self-management of diabetes advise patients that a snack containing up to 10g of carbohydrate can be eaten without correcting with an insulin bolus. This study will look to either confirm or dispel this assumption in the interest of reducing postprandial hyperglycaemia by recruiting paediatric patients diagnosed with Type 1 diabetes and using CGM to monitor their interstitial glucose levels after 5 snacks with varying carbohydrate quantities.

  • REC name

    East Midlands - Nottingham 1 Research Ethics Committee

  • REC reference

    19/EM/0322

  • Date of REC Opinion

    16 Oct 2019

  • REC opinion

    Favourable Opinion