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Postprandial Glucose Control in Type 1 Diabetes: Importance of the Gastric Emptying Rate

1
Department of Molecular Medicine and Medical Biotechnology, Federico II University, 80131 Naples, Italy
2
Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(7), 1559; https://doi.org/10.3390/nu11071559
Received: 20 June 2019 / Revised: 5 July 2019 / Accepted: 8 July 2019 / Published: 10 July 2019
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PDF [235 KB, uploaded 10 July 2019]
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Abstract

The achievement of optimal post-prandial (PP) glucose control in patients with type 1 diabetes (T1DM) remains a great challenge. This review summarizes the main factors contributing to PP glucose response and discusses the likely reasons why PP glucose control is rarely achieved in T1DM patients. The macronutrient composition of the meal, the rate of gastric emptying and premeal insulin administration are key factors affecting the PP glucose response in T1DM. Although the use of continuous insulin infusion systems has improved PP glucose control compared to conventional insulin therapy, there is still need for further ameliorations. T1DM patients frequently present a delayed gastric emptying (GE) that produces a lower but more prolonged PP hyperglycemia. In addition, delayed GE is associated with a longer time to reach the glycemic peak, with a consequent mismatch between PP glucose elevation and the timing of premeal insulin action. On this basis, including GE time and meal composition in the algorithms for insulin bolus calculation of the insulin delivery systems could be an important step forward for optimization of PP glucose control in T1DM. View Full-Text
Keywords: postprandial glucose; gastric emptying; meal; premeal insulin postprandial glucose; gastric emptying; meal; premeal insulin
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Lupoli, R.; Pisano, F.; Capaldo, B. Postprandial Glucose Control in Type 1 Diabetes: Importance of the Gastric Emptying Rate. Nutrients 2019, 11, 1559.

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