- Effects of the Glycemic Index of Dietary Carbohydrates on Insulin Requirement in Type 1 Diabetics on Continuous Subcutaneous Insulin Infusion.
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Hye Jin Lee, Kwon Beom Kim, Kyung Ah Han, Kyung Wan Min, Eung Jin Kim, Ki Nam Kim
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Korean Diabetes J. 2005;29(1):72-77. Published online January 1, 2005
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 Abstract
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- BACKGROUND
For ideal glycemic control, the pump user should have a meal planning approach that is as precise and flexible as the pump. Counting carbohydrate is simple and works, but is not a perfect system. Many researches indicate that not all carbohydrates create an equal response when it comes to their effect on blood glucose levels. For a better match between the glucose and insulin profiles, the glycemic index as along with counting carbohydrate might be considered. Therefore, we investigated whether the same amount of carbohydrates with different glycemic indices might require different insulin doses. METHODS: Five type 1 diabetics, using portable external pumps, whose basal rates were correctly set to maintain their blood glucose levels with in the target range under 12 hours fasting conditions, were enrolled. 50 grams of 4 carbohydrate containing foods, with different glycemic indices, were administered for 4 consecutive days to diabetic patients in an overnight fasting state. The test foods were rice, apple, milk and orange juice, for which the glycemic indices were 83, 54, 39 and 97, respectively. The insulin requirement for each food was determined so that the blood glucose level reached the target range four hours after eating. RESULTS: The glycemic indices for each food/rice ratio were significantly correlated with the insulin requirement (r = 0.586, P < 0.01). CONCLUSION: The meal-related insulin dose should be changed according to the glycemic index of the meal. Therefore both amount and source of carbohydrate determine the glucose and insulin responses of type 1 diabetic subjects
- Insulin Requirement for Korean Type 1 Diabetics using Continuous Insulin Infusion with Portable External Pumps.
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Hye Jin Lee, Kwon Beom Kim, Kyung Ah Han, Kyung Wan Min, Eung Jin Kim
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Korean Diabetes J. 2004;28(6):538-546. Published online December 1, 2004
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Abstract
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- BACKGROUND
Insulin pumps can be extremely effective in achieving a normal or near-normal blood glucose level in type 1 diabetic patients. For designing a pump program in western countries, it has been recommended that approximately half of the daily insulin dose should given in the basal infusion, and the other half make up the meal-related bolus dose. However, peoples' diet composition is quite different among the many countries. The carbohydrate composition in the Korean diet is higher (60~65%) than that in the western diet (45~50%). Carbohydrate is much more glycemic than protein or fat. Therefore, we evaluated the basal and meal-related insulin requirements for Korean type 1 diabetics by using continuous insulin infusion with portable external pumps. METHODS: Twenty three type 1 diabetic patients were admitted for continuous subcutaneous insulin infusion (CSII), and they were given a calculated diet (60% carbohydrate, 20% protein, and 20% fat). The Basal rates were set for the blood glucose levels to remain in the target range during 12 hour fasting state. The meal related bolus dose was set to remain in the target range at the premeal state. RESULTS: The daily total insulin requirement was 99.7 +/-0.3% of prepump insulin dose, and 0.57 +/-0.21 unit per kilogram of body weight. The basal and mealrelated insulin dose among the daily total insulin requirements were 33.7 +/-8.6 and 66.3 +/-8.6%, respectively. The daily total, basal and meal-related insulin requirements were not significantly related with body weight, but the glucose disposal rate per 1unit of insulin was significantly related with body weight (r=-0.424, P <0.05). CONCLUSION: Although the daily total insulin requirement per kilogram of body weight in Korean type 1 diabetics was similar to that in western diabetics, the basal insulin requirements were less and the meal-related insulin requirements were more than that in western diabetics.
- Serum CRP levels are associated with Estradiol levels and Insulin Resistance Syndrome in Korean Women.
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Kwon Beom Kim, Hee Young Kim, Kye Won Lee, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Chol Shin, Sei Hyun Baik, Dong Seop Choi
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Korean Diabetes J. 2004;28(4):324-337. Published online August 1, 2004
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Abstract
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- BACKGROUND
Several reports have recently suggested a positive correlation between components of metabolic syndrome (MS) or insulin resistance syndrome (IRS) and markers of the acute-phase response, including C-reactive protein (CRP). These results imply that MS and type 2 diabetes are the results of ongoing inflammatory process. Whether estrogen plays a beneficial role in preventing atherosclerosis has been a matter of controversy. The objective of this study was to evaluate the relationship between the serum levels of estradiol (E2) and the components of the MS and CRP in nondiabetic subjects of Ansan Health Study (AHS). METHODS: Eight-hundred and ninety-one healthy non-diabetic women aged over 18 years were enrolled. After measurements of the anthropometric and metabolic parameters, correlation and multiple linear regression analyses were performed with regard to the CRP level, as a dependent variable, and with regards to age, blood pressure (BP), body mass index (BMI), lipid profiles, fasting plasma glucose levels, HOMA-IR and fat content as independent variables. RESULTS: In the multiple linear regression analysis, the CRP concentration was found to be independently associated with the E2 level, total fat content, leukocyte counts, and total cholesterol level in all subjects and the serum E2 levels was correlated with age, HOMA-IR, total cholesterol and the CRP level. When subjects were grouped according to their number of MS or IRS components, the CRP levels were found to show statistically significant differences between the MS and IRS groups. CONCLUSION: As a marker of chronic inflammation, the serum CRP level was independently associated with the components of MS and IRS. Also, the serum CRP and E2 levels were positively correlated. These results suggest that estrogen and CRP might play some independent roles in chronic inflammation which is a part of MS and IRS.
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