Functional insulin therapy in type 1 diabetics: Short-term effects on weight and nutritional intake

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Published Apr 6, 2024
https://doi.org/10.62438/tunismed.v102i4.4629
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Vol. 102 No. 4 (2024): Tunis Med apr 2024

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Kamilia Ounaissa
Outpatient Department, Zouhair Kallel National Institute of Nutrition and Food Technology, Tunis, Tunisia
Meriem Madhbouh
Department of Nutritional Diseases "A", Zouhair Kallel National Institute of Nutrition, Tunis, Tunisia
Faten Mahjoub
Department of Nutritional Diseases "A", Zouhair Kallel National Institute of Nutrition, Tunis, Tunisia
Nadia Ben Amor
Department of Nutritional Diseases "A", Zouhair Kallel National Institute of Nutrition, Tunis, Tunisia
Haifa Abdesselem
Outpatient Department, Zouhair Kallel National Institute of Nutrition and Food Technology, Tunis, Tunisia
Ines Lahmar
Department of Nutritional Diseases "A", Zouhair Kallel National Institute of Nutrition, Tunis, Tunisia
Amel Gammoudi
Department of Nutritional Diseases "A", Zouhair Kallel National Institute of Nutrition, Tunis, Tunisia
Chiraz Amrouche
Outpatient Department, Zouhair Kallel National Institute of Nutrition and Food Technology, Tunis, Tunisia
Henda Jamoussi Kamoun
Department of Nutritional Diseases "A", Zouhair Kallel National Institute of Nutrition, Tunis, Tunisia

Abstract

Introduction-Aim: Flexible insulin therapy is currently considered the gold standard therapy of type 1 diabetes. We aimed to study the evolution of glycemic control, weight and nutritional intake of a group of patients with type 1 diabetes, three months after the initiation of functional insulin therapy (FIT).


 Methods:  This was a prospective longitudinal study having included 30 type 1 diabetic patients hospitalized for education to FIT. Each patient underwent an assessment of glycemic control (glycated hemoglobin (A1C) and number of hypoglycemia), weight and nutritional intake before FIT and 3 months after the initiation of this educative approach.


Results: The mean age of patients was 21,8 ± 7,9 years and the sex ratio was 0,5. The mean duration of diabetes was 7,2 ± 6 years. Three months after initiation of FIT, we observed a significant lowering of A1C, which went from 9,2 ± 1,6% to 8,3 ± 1,4% (p<0,001) of the number of minor hypoglycemia (p=0,001) and that of severe hypoglycemia (p= 0,021). the average weight went from 64,6 ± 13,1 kg to 65,5 ± 13,5 kg (p = 0,040) with a significant increase in BMI (p = 0,041). Weight gain was observed in 67% of patients. This weight gain contrasted with a significant decrease in caloric (p = 0,040) and in carbohydrates intakes (p = 0,027).


Conclusion:


Weight gain, associated with better glycemic control, should encourage the healthcare team to strengthen therapeutic education of patients undergoing FIT in order to limit weight gain.

Keywords:

Type 1 diabetes, Functional insulin therapy, Weight, Glycemic control

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