Journal: Diabetes, Obesity and Metabolism

Abbreviation

Diabetes Obes Metab

Publisher

Wiley

Journal Volumes

ISSN

1462-8902
1463-1326

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Publications 1 - 3 of 3
  • Cover Image, Volume 23, Issue 9
    Item type: Other Journal Item
    Lehmann, Vera; Tripyla, Afroditi; Herzig, David; et al. (2021)
    Diabetes, Obesity and Metabolism
    The cover image is based on the Brief Report The impact of postbariatric hypoglycaemia on driving performance: A randomized, single-blind, two-period, crossover study in a driving simulator by Vera Lehmann et al., https://doi.org/10.1111/dom.14456.
  • The impact of postbariatric hypoglycaemia on driving performance: A randomized, single-blind, two-period, crossover study in a driving simulator
    Item type: Journal Article
    Lehmann, Vera; Tripyla, Afroditi; Herzig, David; et al. (2021)
    Diabetes, Obesity and Metabolism
    Postbariatric hypoglycemia (PBH) is an increasingly recognized complication of bariatric surgery, but its effect on daily functioning remains unclear. In this randomized single-blind crossover trial we assessed driving performance in patients with PBH. Ten active drivers with PBH (8 females, age 38.2 ± 14.7 years, BMI 27.2 ± 4.6 kg/m2) received 75 g glucose to induce PBH in the late postprandial period and aspartame to leave glycemia unchanged, on two different occasions. A simulator was driven during 10 min before (D0) and 20 (D1), 80 (D2), 125 (D3) and 140 min (D4) after the glucose/aspartame ingestion, reflecting the expected blood glucose (BG) increase (D1), decrease (D2), and hypoglycemia (D3, D4). Seven driving features indicating impaired driving were integrated in a Bayesian hierarchical regression model to assess the difference in driving performance after glucose/aspartame ingestion. Mean ± standard deviation peak and nadir BG after glucose were 182 ± 24 and 47 ± 14 mg/dL, while BG was stable after aspartame (85 ± 4 mg/dL). Despite the lack of a difference in symptom perception, driving performance was significantly impaired after glucose vs. aspartame during D4 (posterior probability 98.2%). Our findings suggest that PBH negatively affects driving performance.
  • Effect of nutrition on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully automated closed‐loop insulin therapy
    Item type: Journal Article
    Banholzer, Nicolas; Herzig, David; Piazza, Camillo; et al. (2021)
    Diabetes, Obesity and Metabolism
    Fully automated closed‐loop insulin delivery may offer a novel way to manage diabetes in hospital. However, postprandial glycaemic control remains challenging. We aimed to assess the effect of nutritional intake on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully closed‐loop insulin therapy. The effects of different meal types and macronutrient composition on sensor glucose time‐in‐target (TIT, 3.9‐10.0 mmol/L) and mean sensor glucose were assessed with hierarchical linear models using a Bayesian estimation approach. TIT was lower and the mean sensor glucose slightly higher, after breakfast compared with lunch and dinner, whereas the insulin dose was higher. Across meals, when carbohydrates were replaced by fat, or to a lesser extent by protein, postprandial glucose control improved. For breakfast, a 3.9% improvement in TIT was observed when 10% of the energy from carbohydrates was replaced by fat. Improvements were slightly lower during lunch and dinner (3.2% and 3.4%) or when carbohydrates were replaced by protein (2.2 and 2.7%, respectively). We suggest that reducing carbohydrate at the expense of fat or protein, could further improve glucose control during fully closed‐loop insulin therapy in hospital.
Publications 1 - 3 of 3