Effects of Bedtime Snack Composition on Overnight Glucose in Children and Adolescents With Type 1 Diabetes
Bedtime Snack Composition and Overnight Glycemic Profiles in Children and Adolescents With Type 1 Diabetes Using Multiple Daily Injections: A Randomized Crossover Study
This study compared four types of bedtime snacks in children and adolescents with type 1 diabetes treated with multiple daily insulin injections. The aim was to determine whether bedtime snack nutrient composition affects overnight glucose levels.
Participants received four different bedtime snacks: carbohydrate alone, carbohydrate with protein, carbohydrate with fat, and carbohydrate with fiber. The order of the four snack types was randomly assigned. Each snack type was consumed at 9:00 PM for three consecutive nights without an additional insulin dose for the snack. All participants received all four snack types during the study.
Overnight glucose levels were measured from 9:00 PM to 9:00 AM using a blinded continuous glucose monitoring system. The primary outcome was the percentage of time glucose levels remained between 70 and 180 mg/dL during the overnight period. Secondary outcomes included measures of hypoglycemia, hyperglycemia, glucose variability, and changes in glucose levels during different periods of the night.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
-
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Fatih
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Istanbul, Fatih, Turecko (Türkiye), 34098
- Istanbul University Cerrahpasa-Cerrahpasa Faculty of Medicine
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dítě
- Dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
Age 6-18 years Diagnosis of type 1 diabetes for more than 1 year Completion of the remission period Treatment with multiple daily insulin injections Completion of all three stages of carbohydrate-counting education Ability to perform capillary blood glucose monitoring at least four times daily Total daily insulin dose >0.5 U/kg/day Mean HbA1c <9.6% during the preceding 3 months
Exclusion Criteria:
Insulin pump or sensor-augmented pump therapy Incomplete carbohydrate-counting education Impaired awareness of hypoglycemia Intestinal malabsorption Delayed gastric emptying Celiac disease or any other condition requiring dietary restriction Cystic fibrosis or other gastrointestinal disorders Diabetes-related chronic complications Physical or mental disability limiting adherence to study procedures Eating behavior disorders Active infection
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Crossover Assignment
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
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Experimentální: Sequence 1: CHO First
Participants received the four bedtime snack interventions in the following order: CHO, CHO+PRO, CHO+FAT, and CHO+FIB.
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Participants consumed an apple as a carbohydrate-only bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed a high-protein fresh cheese bedtime snack containing carbohydrate and protein at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed an apple with nuts as a carbohydrate-plus-fat bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed rye crispbread as a carbohydrate-plus-fiber bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
|
|
Experimentální: Sequence 2: CHO+PRO First
Participants received the four bedtime snack interventions in the following order: CHO+PRO, CHO+FAT, CHO+FIB, and CHO.
|
Participants consumed an apple as a carbohydrate-only bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed a high-protein fresh cheese bedtime snack containing carbohydrate and protein at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed an apple with nuts as a carbohydrate-plus-fat bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed rye crispbread as a carbohydrate-plus-fiber bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
|
|
Experimentální: Sequence 3: CHO+FAT First
Participants received the four bedtime snack interventions in the following order: CHO+FAT, CHO+FIB, CHO, and CHO+PRO.
|
Participants consumed an apple as a carbohydrate-only bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed a high-protein fresh cheese bedtime snack containing carbohydrate and protein at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed an apple with nuts as a carbohydrate-plus-fat bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed rye crispbread as a carbohydrate-plus-fiber bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
|
|
Experimentální: Sequence 4: CHO+FIB First
Participants received the four bedtime snack interventions in the following order: CHO+FIB, CHO, CHO+PRO, and CHO+FAT.
|
Participants consumed an apple as a carbohydrate-only bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed a high-protein fresh cheese bedtime snack containing carbohydrate and protein at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed an apple with nuts as a carbohydrate-plus-fat bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
Participants consumed rye crispbread as a carbohydrate-plus-fiber bedtime snack at 21:00.
The snack was consumed within 10 minutes, and no additional bolus insulin was administered for the snack.
This intervention was followed for three consecutive nights.
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Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Overnight Time in Range (70-180 mg/dL)
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of continuous glucose monitoring (CGM) readings within the target glucose range of 70-180 mg/dL during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Mean Overnight Sensor Glucose
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Mean continuous glucose monitoring (CGM) glucose concentration during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
|
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Percentage of Overnight Time in Tight Range (70-140 mg/dL)vernight Sensor Glucose
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of CGM readings within the glucose range of 70-140 mg/dL during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of Overnight Time Below Range (<70 mg/dL)
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of CGM readings below 70 mg/dL during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of Overnight Time Below Range (<54 mg/dL)
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of CGM readings below 54 mg/dL during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of Overnight Time Above Range (>180 mg/dL)
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of CGM readings above 180 mg/dL during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of Overnight Time Above Range (>250 mg/dL)
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Percentage of CGM readings above 250 mg/dL during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Coefficient of Variation of Overnight Sensor Glucose
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Coefficient of variation of CGM glucose values during the overnight period, expressed as a percentage
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12 hours after bedtime snack consumption (21:00-09:00)
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Peak Overnight Sensor Glucose
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Highest CGM glucose concentration recorded during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Nadir Overnight Sensor Glucose
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Lowest CGM glucose concentration recorded during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Peak-to-Nadir Overnight Glucose Amplitude
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Difference between the highest and lowest CGM glucose concentrations during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Incremental Area Under the Overnight Glucose Curve
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Incremental area under the CGM glucose curve during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Number of Overnight Hypoglycemic Events
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Number of hypoglycemic events occurring during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Number of Overnight Hyperglycemic Events
Časové okno: 12 hours after bedtime snack consumption (21:00-09:00)
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Number of hyperglycemic events occurring during the overnight period following each bedtime snack intervention.
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12 hours after bedtime snack consumption (21:00-09:00)
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- BEDTIME-SNACK-T1D
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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