Carbohydrate intake and insulin requirement in children, adolescents and young adults with cystic fibrosis-related diabetes: A multicenter comparison to type 1 diabetes
Summary Background & aims In cystic fibrosis-related diabetes (CFRD), energy needs differ from type 1 (T1D) or type 2 diabetes, and endogenous insulin secretion is not totally absent. We analyzed whether daily carbohydrate intake, its diurnal distribution and insulin requirement per 11 g of carb...
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2015-08, Vol.34 (4), p.732-738 |
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| creator | Scheuing, Nicole Thon, Angelika Konrad, Katja Bauer, Maria Karsten, Claudia Meissner, Thomas Seufert, Jochen Schönau, Eckhard Schöfl, Christof Woelfle, Joachim Holl, Reinhard W |
| description | Summary Background & aims In cystic fibrosis-related diabetes (CFRD), energy needs differ from type 1 (T1D) or type 2 diabetes, and endogenous insulin secretion is not totally absent. We analyzed whether daily carbohydrate intake, its diurnal distribution and insulin requirement per 11 g of carbohydrate differ between CFRD and T1D. Methods Anonymized data of 223 CFRD and 36,780 T1D patients aged from 10 to |
| doi_str_mv | 10.1016/j.clnu.2014.08.016 |
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We analyzed whether daily carbohydrate intake, its diurnal distribution and insulin requirement per 11 g of carbohydrate differ between CFRD and T1D. Methods Anonymized data of 223 CFRD and 36,780 T1D patients aged from 10 to <30 years from the multicenter diabetes registry DPV were studied. Carbohydrate intake and insulin requirement were analyzed using multivariable regression modeling with adjustment for age and sex. Moreover, carbohydrate intake was compared to the respective recommendations (CFRD: energy intake 130% of general population with 45% carbohydrates; T1D: carbohydrate intake 50% of total energy). Results After demographic adjustment, carbohydrate intake (238 ± 4 vs. 191 ± 1 g/d, p < 0.001) and meal-related insulin (0.52 ± 0.02 vs. 0.47 ± 0.004 IU/kg*d, p = 0.001) were higher in CFRD, whereas basal insulin (0.27 ± 0.01 vs. 0.38 ± 0.004 IU/kg*d, p < 0.001) and total insulin requirement per 11 g of carbohydrate (1.15 ± 0.06 vs. 1.70 ± 0.01 IU/d, p < 0.001) were lower compared to T1D. CFRD patients achieved 62% [Q1 ;Q3 : 47; 77] of recommended carbohydrate intake and T1D patients 60% [51; 71] of age- and gender-specific recommended intake ( p < 0.001). CFRD and T1D patients had a carbohydrate intake below healthy peers (79% [58; 100] and 62% [52; 74], p < 0.001). The circadian rhythm of insulin sensitivity persisted in CFRD and the diurnal distribution of carbohydrates was comparable between groups. Conclusions In pediatric and young adult patients, carbohydrate intake and insulin requirement differ clearly between CFRD and T1D. However, both CFRD and T1D patients seem to restrict carbohydrates.]]></description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2014.08.016</identifier><identifier>PMID: 25245859</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Blood Glucose ; Body Mass Index ; Child ; Cystic fibrosis ; Cystic Fibrosis - drug therapy ; Diabetes mellitus ; Diabetes Mellitus, Type 1 - drug therapy ; Dietary carbohydrates ; Dietary Carbohydrates - administration & dosage ; Dietary Carbohydrates - blood ; Dose-Response Relationship, Drug ; Energy Intake ; Female ; Gastroenterology and Hepatology ; Humans ; Insulin - administration & dosage ; Insulin - blood ; Insulin dose ; Linear Models ; Male ; Multivariate Analysis ; Nutritional Requirements ; Prospective Studies ; Recommended Dietary Allowances ; Young Adult</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2015-08, Vol.34 (4), p.732-738</ispartof><rights>Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-5a1b5e57a67e0850c780f9ff6b6de289e3a9b2965ac27018d6db4119c22c96b73</citedby><cites>FETCH-LOGICAL-c455t-5a1b5e57a67e0850c780f9ff6b6de289e3a9b2965ac27018d6db4119c22c96b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2014.08.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25245859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scheuing, Nicole</creatorcontrib><creatorcontrib>Thon, Angelika</creatorcontrib><creatorcontrib>Konrad, Katja</creatorcontrib><creatorcontrib>Bauer, Maria</creatorcontrib><creatorcontrib>Karsten, Claudia</creatorcontrib><creatorcontrib>Meissner, Thomas</creatorcontrib><creatorcontrib>Seufert, Jochen</creatorcontrib><creatorcontrib>Schönau, Eckhard</creatorcontrib><creatorcontrib>Schöfl, Christof</creatorcontrib><creatorcontrib>Woelfle, Joachim</creatorcontrib><creatorcontrib>Holl, Reinhard W</creatorcontrib><creatorcontrib>German/Austrian Diabetes Prospective Documentation Initiative and the BMBF Competence Network Diabetes Mellitus</creatorcontrib><title>Carbohydrate intake and insulin requirement in children, adolescents and young adults with cystic fibrosis-related diabetes: A multicenter comparison to type 1 diabetes</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description><![CDATA[Summary Background & aims In cystic fibrosis-related diabetes (CFRD), energy needs differ from type 1 (T1D) or type 2 diabetes, and endogenous insulin secretion is not totally absent. We analyzed whether daily carbohydrate intake, its diurnal distribution and insulin requirement per 11 g of carbohydrate differ between CFRD and T1D. Methods Anonymized data of 223 CFRD and 36,780 T1D patients aged from 10 to <30 years from the multicenter diabetes registry DPV were studied. Carbohydrate intake and insulin requirement were analyzed using multivariable regression modeling with adjustment for age and sex. Moreover, carbohydrate intake was compared to the respective recommendations (CFRD: energy intake 130% of general population with 45% carbohydrates; T1D: carbohydrate intake 50% of total energy). Results After demographic adjustment, carbohydrate intake (238 ± 4 vs. 191 ± 1 g/d, p < 0.001) and meal-related insulin (0.52 ± 0.02 vs. 0.47 ± 0.004 IU/kg*d, p = 0.001) were higher in CFRD, whereas basal insulin (0.27 ± 0.01 vs. 0.38 ± 0.004 IU/kg*d, p < 0.001) and total insulin requirement per 11 g of carbohydrate (1.15 ± 0.06 vs. 1.70 ± 0.01 IU/d, p < 0.001) were lower compared to T1D. CFRD patients achieved 62% [Q1 ;Q3 : 47; 77] of recommended carbohydrate intake and T1D patients 60% [51; 71] of age- and gender-specific recommended intake ( p < 0.001). CFRD and T1D patients had a carbohydrate intake below healthy peers (79% [58; 100] and 62% [52; 74], p < 0.001). The circadian rhythm of insulin sensitivity persisted in CFRD and the diurnal distribution of carbohydrates was comparable between groups. Conclusions In pediatric and young adult patients, carbohydrate intake and insulin requirement differ clearly between CFRD and T1D. However, both CFRD and T1D patients seem to restrict carbohydrates.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Blood Glucose</subject><subject>Body Mass Index</subject><subject>Child</subject><subject>Cystic fibrosis</subject><subject>Cystic Fibrosis - drug therapy</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Dietary carbohydrates</subject><subject>Dietary Carbohydrates - administration & dosage</subject><subject>Dietary Carbohydrates - blood</subject><subject>Dose-Response Relationship, Drug</subject><subject>Energy Intake</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Humans</subject><subject>Insulin - administration & dosage</subject><subject>Insulin - blood</subject><subject>Insulin dose</subject><subject>Linear Models</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Nutritional Requirements</subject><subject>Prospective Studies</subject><subject>Recommended Dietary Allowances</subject><subject>Young Adult</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhS0EotPCC7BAXrIgg-3EjoNQpWpUfqRKLIC15dg3jKeJPbUdUN6Ix8RhShcsWNk6-s6xrs9F6AUlW0qoeHPYmtHPW0ZosyVyW6RHaEN5zSrayfox2hAmaMUFbc7QeUoHQgivW_kUnTHOGi55t0G_djr2Yb_YqDNg57O-Bay9Ldc0j87jCHezizCBz0XDZu9GG8G_xtqGEZIpevpjWMLsvxd1Hovw0-U9NkvKzuDB9TEkl6oIY3nEYut0DxnSW3yFp4K7NQQiNmE66uhS8DgHnJcjYPoAP0NPBj0meH5_XqBv76-_7j5WN58_fNpd3VSm4TxXXNOeA2-1aIFITkwrydANg-iFBSY7qHXXs05wbVhLqLTC9g2lnWHMdKJv6wv06pR7jOFuhpTV5MqU46g9hDkpKmRXU9qSFWUn1JT5UoRBHaObdFwUJWptSB3U2pBaG1JEqiIV08v7_LmfwD5Y_lZSgHcnAMqUPxxElYwDb8CWGkxWNrj_51_-YzelRmf0eAsLpEOYoy__p6hKTBH1Zd2RdUVoQwhjjah_A-Uvuts</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Scheuing, Nicole</creator><creator>Thon, Angelika</creator><creator>Konrad, Katja</creator><creator>Bauer, Maria</creator><creator>Karsten, Claudia</creator><creator>Meissner, Thomas</creator><creator>Seufert, Jochen</creator><creator>Schönau, Eckhard</creator><creator>Schöfl, Christof</creator><creator>Woelfle, Joachim</creator><creator>Holl, Reinhard W</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150801</creationdate><title>Carbohydrate intake and insulin requirement in children, adolescents and young adults with cystic fibrosis-related diabetes: A multicenter comparison to type 1 diabetes</title><author>Scheuing, Nicole ; Thon, Angelika ; Konrad, Katja ; Bauer, Maria ; Karsten, Claudia ; Meissner, Thomas ; Seufert, Jochen ; Schönau, Eckhard ; Schöfl, Christof ; Woelfle, Joachim ; Holl, Reinhard W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-5a1b5e57a67e0850c780f9ff6b6de289e3a9b2965ac27018d6db4119c22c96b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Blood Glucose</topic><topic>Body Mass Index</topic><topic>Child</topic><topic>Cystic fibrosis</topic><topic>Cystic Fibrosis - drug therapy</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Dietary carbohydrates</topic><topic>Dietary Carbohydrates - administration & dosage</topic><topic>Dietary Carbohydrates - blood</topic><topic>Dose-Response Relationship, Drug</topic><topic>Energy Intake</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Humans</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - blood</topic><topic>Insulin dose</topic><topic>Linear Models</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Nutritional Requirements</topic><topic>Prospective Studies</topic><topic>Recommended Dietary Allowances</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scheuing, Nicole</creatorcontrib><creatorcontrib>Thon, Angelika</creatorcontrib><creatorcontrib>Konrad, Katja</creatorcontrib><creatorcontrib>Bauer, Maria</creatorcontrib><creatorcontrib>Karsten, Claudia</creatorcontrib><creatorcontrib>Meissner, Thomas</creatorcontrib><creatorcontrib>Seufert, Jochen</creatorcontrib><creatorcontrib>Schönau, Eckhard</creatorcontrib><creatorcontrib>Schöfl, Christof</creatorcontrib><creatorcontrib>Woelfle, Joachim</creatorcontrib><creatorcontrib>Holl, Reinhard W</creatorcontrib><creatorcontrib>German/Austrian Diabetes Prospective Documentation Initiative and the BMBF Competence Network Diabetes Mellitus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scheuing, Nicole</au><au>Thon, Angelika</au><au>Konrad, Katja</au><au>Bauer, Maria</au><au>Karsten, Claudia</au><au>Meissner, Thomas</au><au>Seufert, Jochen</au><au>Schönau, Eckhard</au><au>Schöfl, Christof</au><au>Woelfle, Joachim</au><au>Holl, Reinhard W</au><aucorp>German/Austrian Diabetes Prospective Documentation Initiative and the BMBF Competence Network Diabetes Mellitus</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carbohydrate intake and insulin requirement in children, adolescents and young adults with cystic fibrosis-related diabetes: A multicenter comparison to type 1 diabetes</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>34</volume><issue>4</issue><spage>732</spage><epage>738</epage><pages>732-738</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract><![CDATA[Summary Background & aims In cystic fibrosis-related diabetes (CFRD), energy needs differ from type 1 (T1D) or type 2 diabetes, and endogenous insulin secretion is not totally absent. We analyzed whether daily carbohydrate intake, its diurnal distribution and insulin requirement per 11 g of carbohydrate differ between CFRD and T1D. Methods Anonymized data of 223 CFRD and 36,780 T1D patients aged from 10 to <30 years from the multicenter diabetes registry DPV were studied. Carbohydrate intake and insulin requirement were analyzed using multivariable regression modeling with adjustment for age and sex. Moreover, carbohydrate intake was compared to the respective recommendations (CFRD: energy intake 130% of general population with 45% carbohydrates; T1D: carbohydrate intake 50% of total energy). Results After demographic adjustment, carbohydrate intake (238 ± 4 vs. 191 ± 1 g/d, p < 0.001) and meal-related insulin (0.52 ± 0.02 vs. 0.47 ± 0.004 IU/kg*d, p = 0.001) were higher in CFRD, whereas basal insulin (0.27 ± 0.01 vs. 0.38 ± 0.004 IU/kg*d, p < 0.001) and total insulin requirement per 11 g of carbohydrate (1.15 ± 0.06 vs. 1.70 ± 0.01 IU/d, p < 0.001) were lower compared to T1D. CFRD patients achieved 62% [Q1 ;Q3 : 47; 77] of recommended carbohydrate intake and T1D patients 60% [51; 71] of age- and gender-specific recommended intake ( p < 0.001). CFRD and T1D patients had a carbohydrate intake below healthy peers (79% [58; 100] and 62% [52; 74], p < 0.001). The circadian rhythm of insulin sensitivity persisted in CFRD and the diurnal distribution of carbohydrates was comparable between groups. Conclusions In pediatric and young adult patients, carbohydrate intake and insulin requirement differ clearly between CFRD and T1D. However, both CFRD and T1D patients seem to restrict carbohydrates.]]></abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>25245859</pmid><doi>10.1016/j.clnu.2014.08.016</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Blood Glucose Body Mass Index Child Cystic fibrosis Cystic Fibrosis - drug therapy Diabetes mellitus Diabetes Mellitus, Type 1 - drug therapy Dietary carbohydrates Dietary Carbohydrates - administration & dosage Dietary Carbohydrates - blood Dose-Response Relationship, Drug Energy Intake Female Gastroenterology and Hepatology Humans Insulin - administration & dosage Insulin - blood Insulin dose Linear Models Male Multivariate Analysis Nutritional Requirements Prospective Studies Recommended Dietary Allowances Young Adult |
| title | Carbohydrate intake and insulin requirement in children, adolescents and young adults with cystic fibrosis-related diabetes: A multicenter comparison to type 1 diabetes |
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