Timing of Pre-meal Insulin Versus Accurate Carbohydrate Counting in Youth With Type 1 Diabetes

NCT01209312 | Completed

• 1 other identifier: 09-0931
• Study Type: interventional
• Target: 21
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators are hoping to figure out how youth with type 1 diabetes can best control their blood glucose levels after meals, by determining whether accurate carbohydrate dosing or the timing of the bolus is more important. There is evidence to suggest that each strategy is important for blood glucose control. Unfortunately, for some people, prebolusing is difficult, because they may not know how much they are going to eat. To give an exact dose of insulin 20 minutes before a meal can be difficult. In this study, the investigators would like to show that taking even just part of the insulin bolus 20 minutes before the meal is preferable to waiting until mealtime and taking the entire bolus. To do this, the investigators will have 24 patients in the study, who will each spend 4 mornings at The investigators clinic. The order of the visits will be selected randomly. The visits will include: taking full bolus at mealtime, taking full bolus 20 minute before mealtime, taking ½ bolus at mealtime, and taking ½ bolus 20 minutes before mealtime. At each visit, the person will eat the same meal, but the timing and amount of the bolus will be different. The investigators will measure the blood glucose levels with a blood glucose meter, and also with a laboratory test called YSI. The investigators will also be measuring the glucose levels under the person's skin with a continuous glucose monitor. The investigators will compare the area under the curve for the different visits, as well as the glucose levels at different points after the meal.

Conditions

Type 1 Diabetes

Outcome Measures

Primary Outcomes (1)

• Blood glucose area under the curve

  4 hours post-meal

Study Arms (4)

full bolus -20

EXPERIMENTAL

Will administer full insulin bolus 20 minutes prior to meal

Other: Bolus timing and dosing

Full bolus, T0

EXPERIMENTAL

Will administer full meal bolus at the start of the meal

Other: Bolus timing and dosing

1/2 bolus, T-20

EXPERIMENTAL

Will only give half the insulin dose 20 minutes before meal

Other: Bolus timing and dosing

1/2 bolus T0

EXPERIMENTAL

Will give half the amount of insulin at the time of the meal

Other: Bolus timing and dosing

Interventions

Bolus timing and dosing OTHER

We will be altering the timing and dosages of the prescribed meal bolus.

1/2 bolus T0; 1/2 bolus, T-20; Full bolus, T0; full bolus -20

Eligibility Criteria

• Age: 7 Years - 21 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Ages 7-21, inclusive
• Diagnosis of type 1 diabetes for \>1 year
• Using carbohydrate counting to dose mealtime insulin
• Using an insulin pump and continuous glucose monitor to control diabetes
• HbA1c \<10%

You may not qualify if:

• Celiac disease or other GI abnormality
• Severe hypoglycemia in the past 6 months
• Pregnancy
• Documented hypoglycemia unawareness

Sponsors & Collaborators

• University of Colorado, Denver: lead

Study Sites (1)

Barbara Davis Center for Childhood Diabetes

Aurora, Colorado, 80045, United States

Location

MeSH Terms

Conditions

Diabetes Mellitus, Type 1

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Autoimmune Diseases; Immune System Diseases

Study Officials

• H Peter Chase, MD

  University of Colorado, Denver

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 23, 2010
• First Posted: September 27, 2010
• Study Start: December 1, 2009
• Primary Completion: December 1, 2010
• Study Completion: December 1, 2010
• Last Updated: November 22, 2012

Record last verified: 2012-11

Locations

US (1)