Insulin Management for Type 1 Diabetic Patients During Social Alcohol Consumption: The SPRITZ Study

(E-pub Ahead of Print)

Author(s): Elisa Cipponeri*, Cesare Blini, Christian Lamera, Valentina De Mori, Giovanni Veronesi, Antonio Carlo Bossi*.

Journal Name: Current Diabetes Reviews

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Background: No data are available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and proteins-containing food, as often the case during social happenings or “happy hours”. Introduction This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif (“Spritz” and chips).

Method: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated-measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting.

Results: After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected.

Conclusion: A personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on psycho-affective dimension. Further studies are mandatory to confirm such very preliminary results.

Keywords: Type 1 diabetes, pump therapy, continuous glucose monitoring, CHO counting, Fat and Protein derived insulin units, alcohol consumption.

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(E-pub Ahead of Print)
DOI: 10.2174/1573399815666190507121332
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