Splitting Mealtime Insulin Doses for Mixed Fat and Protein Meals in Children and Adolescents with Type 1 Diabetes Using Multiple Daily Injection Regimen: A Randomized Cross-Over Trial

Table 2

Comparisons between the three insulin dosing interventions used for the mixed fat and protein test meals regarding prandial insulin doses and postprandial glycemic responses among the study participants.

	Intervention A; (100% ICR (lispro) ± 3-hr ISF-calculated correction dose (lispro)) (n = 43)	Intervention B; (130% ICR; 60% premeal (lispro) + 40% postmeal (lispro)); (n = 43)	Intervention C; (130% ICR; 60% premeal (lispro) + 40% postmeal (regular insulin)); (n = 43)	P1 value	P2 value	P3 value	P4 value
Premeal dose (units), median (IQR)	4.0 (2.5–5.5)	3.5 (2.0–4.5)	3.5 (2–4.5)	<0.001	<0.001	>0.99	<0.001
Postmeal dose (units), median (IQR)	0 (0–1.5)	2.0 (1.5–2.5)	2 (1.5–2.5)	<0.001	<0.001	>0.99	<0.001
Total dose (units), median (IQR)	4.0 (3.5–5.5)	5.5 (3.5–7.0)	5.5 (3.5–7.0)	<0.001	<0.001	>0.99	<0.001
Premeal BG level (mg/dL), median (IQR)	159 (125–175)	148 (117–174)	140 (120–165)	0.57	0.09	0.41	0.22
Peak postprandial BG level (mg/dL), median (IQR)	194 (150–230)	175 (124–208)	175 (130–218)	0.09	0.07	0.89	0.21
Time-to-peak postprandial BG level (hr), median (IQR)	4 (3–5)	4 (2–5)	4 (2–5)	0.66	0.06	0.31	0.34
Lowest postprandial BG level (mg/dL), median (IQR)	88 (68–115)	90 (65–122)	79 (63–106)	0.29	0.10	0.01	0.02
Time to lowest postprandial BG level (hr), median (IQR)	2 (1–4)	2 (1–3)	3 (2–5)	0.75	0.11	0.07	0.19
Participants with postprandial BG levels above 180 mg/dL, n (%)	27 (62.8%)	20 (46.5%)	21 (48.8%)	0.16	0.18	>0.99	0.13

BG, blood glucose; ICR, insulin-to-carbohydrate ratio, ISF, insulin sensitivity factor; IQR, interquartile range. P1: p-value for comparisons between Interventions A and B. P2: p-value for comparisons between Interventions A and C. P3: p-value for comparisons between Interventions B and C. P4: p-value for comparisons between the three interventions together.