Low-fat vs. high-fat bedtime snacks in children and adolescents with type 1 diabetes

  1. Darrell Wilson1,*,
  2. H Peter Chase2,
  3. Craig Kollman3,
  4. Dongyuan Xing3,
  5. Kimberly Caswell1,
  6. Michael Tansey4,
  7. Larry Fox5,
  8. Stuart Weinzimer6,
  9. Roy Beck3,
  10. Katrina Ruedy3,
  11. William Tamborlane6,
  12. the Diabetes Research in Children Network (DirecNet) Study Group1

Article first published online: 28 JUL 2008

DOI: 10.1111/j.1399-5448.2008.00393.x

Issue

Pediatric Diabetes

Pediatric Diabetes

Volume 9, Issue 4pt1, pages 320–325, August 2008

Additional Information

How to Cite

Wilson, D., Chase, H. P., Kollman, C., Xing, D., Caswell, K., Tansey, M., Fox, L., Weinzimer, S., Beck, R., Ruedy, K., Tamborlane, W. and the Diabetes Research in Children Network (DirecNet) Study Group (2008), Low-fat vs. high-fat bedtime snacks in children and adolescents with type 1 diabetes. Pediatric Diabetes, 9: 320–325. doi: 10.1111/j.1399-5448.2008.00393.x

Author Information

  1. 1

    Division of Pediatric Endocrinology and Diabetes, Stanford University, Stanford, CA, USA

  2. 2

    Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, CO, USA

  3. 3

    Jaeb Center for Health Research, Tampa, FL, USA

  4. 4

    Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA

  5. 5

    Nemours Children’s Clinic, Jacksonville, FL, USA

  6. 6

    Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA

*Darrell Wilson, MD c/o DirecNet Coordinating Center Jaeb Center for Health Research 15310 Amberly Drive, Suite 350 Tampa, FL 33647 USA. Tel: +813-975-8690; fax: +813-903-8227; e-mail: direcnet@jaeb.org

Publication History

  1. Issue published online: 28 JUL 2008
  2. Article first published online: 28 JUL 2008
  3. Submitted 12 November 2007. Accepted for publication 8 February 2008

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Keywords:

  • glucose sensor(s);
  • hypoglycemia;
  • web-based data collections

Objective:  The purpose of this study was to determine whether, in a group of children with type 1 diabetes using insulin pump, a prebedtime snack with a relatively high fat content provides greater protection from nocturnal hypoglycemia than a snack containing the same amount of carbohydrate and protein but a lower fat content.

Research design and methods:  Ten subjects, aged 6 to <18 yr, in a trial evaluating the Abbott Navigator glucose sensor, agreed to this ancillary study. On 12 or more separate nights, each subject was randomized by a Web site to a carbohydrate–low-fat (30 g CHO, 2.5 g protein, and 1.3 g fat; 138 kcal) snack or a carbohydrate–high-fat (30 g CHO, 2 g protein, and 20 g fat; 320 kcal) snack. Subjects used their usual evening snack algorithm to determine the size (in 15-g carbohydrate increments) and insulin dosage.

Results:  Average glucose on 128 valid study nights before snack was similar in both groups. The proportion of nights with hypoglycemia (a sensor or meter glucose value ≤70 mg/dL) was similar in both groups (19% high fat vs. 20% low fat), as was the proportion of nights with hyperglycemia (a glucose ≥200 mg/dL and at least 50 mg/dL above baseline, 35% high fat vs. 30% low fat).

Conclusions:  There were no statistical differences between the high- and low-fat snacks on the frequency of hyperglycemia or hypoglycemia. This study highlights the feasibility of web-based research in patients’ home environment.

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