‘Negligible’ carbohydrate snacking facilitates basal rate tests
medwireNews: A randomized crossover trial shows that allowing patients with type 1 diabetes “negligible” carbohydrate snacks during extended fasting to determine their basal insulin needs can make the process more tolerable without affecting the results.
Such tests are unpopular with patients “and probably are under-used, leaving open chances for an optimized titration of basal insulin,” say Michael Nauck (St. Josef-Hospital, Bochum, Germany) and co-researchers.
But when 20 patients undergoing 24-hour fasting were allowed snacks of green salad, cucumber salad, and spinach flavored with poached onions (maximum 5.1 g carbohydrate per serving) at usual meal times, their average plasma glucose levels were 2 mg/dL lower than when they ate nothing. The upper limit of the 95% confidence interval (11 mg/dL) fell within the researchers’ prespecified 14 mg/mL noninferiority margin.
Unsurprisingly, the patients preferred being allowed to snack, and were less likely to want to discontinue the fast when snacks were provided.
“It is hoped that basal rate tests according to our protocol will be used in clinical practice, and will motivate patients to participate in such tests, who otherwise would not be willing to consent to a 24 h fasting period,” writes the team in Diabetes, Obesity and Metabolism.
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