[Effect of fragmentation and quality of carbohydrates diet on metabolic control parameters in insulin treated type 2 diabetic individuals]. / Efecto del fraccionamiento y calidad de los hidratos de carbono de la dieta sobre parámetros de control metabólico en sujetos diabéticos tipo 2 insulino requirentes.

ABSTRACT

INTRODUCTION: Currently there is no consensus regarding fragmentation, quantity and quality of carbohydrates (CHO) that should be followed by insulin treated type 2 diabetic individuals (ITT2D). OBJECTIVE: To determine the relationship between the meal times, quality of available CHO in every meal and the metabolic control parameters in ITT2D individuals with a single or double dose of intermediate-acting insulin. METHODS: 40 ITT2D individuals were evaluated, using food surveys to obtain the quantity of CHO, glycemic index (GI), glycemic load (GL) in every meal and meal times. The metabolic control was determined through lab exams (glycated hemoglobin; HbA1c, venous fasting glycaemia) and fasting (FBG), preprandial (PreG), postprandial (PostG) and bed time (BTG) capilar glycaemia using a glucometer. Statistical analysis were applied considering significant as p<0,05. RESULTS: Individuals recorded an average of 4,9 ± 1,1 meals a day. It was found an asociation between lunch GL and Post G (r=0,317; p<0,05) and BTG (r=0,321; p<0,05). BTG was inversely correlated with the meals' distribution (r = -0,346; p<0,05) and there was a trend to show lower values of BTG with individuals conducting ≥5 meals per day. It was observed that FBG predicts a 65%the variability of HbA1c (r =0,805; r2 =0,648; p<0,001). CONCLUSION: The meal times in ITT2D individuals with s single or doublé dose of intermédiate-acting insulin could improve BTG.

RESUMEN

Introducción: Actualmente no existe consenso en relación al fraccionamiento, cantidad y calidad de los hidratos de carbono (CHO) que debieran seguir los sujetos diabéticos tipo 2 insulino requirentes (DM2IR). Objetivo: Determinar la relación entre el fraccionamiento de la dieta, la calidad de CHO disponibles en cada tiempo de comida y los parámetros de control metabólico en sujetos con DM2IR con una o doble dosis de insulina de acción intermedia. Métodos: Se evaluaron a 40 sujetos con DM2IR, mediante encuestas alimentarias para obtener la cantidad de CHO, índice glicémico (IG), carga glicémica (CG) de los tiempos de comida y el fraccionamiento de la dieta. El control metabólico se determinó por exámenes de laboratorio (hemoglobina glicada; HbA1c, glicemia venosa de ayuno) y glicemias capilares de ayuno (GlicA), preprandiales (GlicPre), postprandiales (GlicPost) y "antes de dormir" (GlicAd) con hemoglucotest. Se aplicaron análisis estadísticos considerando significativo un p.