Glycaemic response to three main meals or five smaller meals for patients on rapid-acting insulin

Abstract

Objective: To compare seven-point blood glucose profiles of patients with type 2 diabetes mellitus using rapid-acting insulin, when daily calories were provided as three main meals versus five smaller meals (three main meals + two snacks), while maintaining the same total daily calorie intake and composition of carbohydrates, fats and protein.

Design: A cross-over study.

Setting: Xiamen University Zhongshan Hospital, China.

Subjects: Over a four week period, 22 patients with type 2 diabetes mellitus using fixed doses of rapid-acting insulin were recruited into the study. Two patients failed to complete the study and data from the remaining 20 subjects were analysed.

Intervention: The subjects using fixed doses of rapid-acting insulin were randomised to five smaller meals versus three main meals treatment periods. Glycaemic response to each meal pattern was measured by seven-point blood glucose profiles.

Main Outcome Measures: The mean seven-point blood glucose levels and the risk of hypoglycaemia.

Results: The mean seven-point blood glucose levels with the pattern of eating five smaller meals was lower than that with three main meals (9.1mmol/L vs. 9.5mmol/L), however the difference was not statistically significant (F=0.524, P=0.474). There were no differences in mean blood glucose levels across the seven-point profile. The risk of hypoglycaemia was also not statistically significant.

Conclusions: This suggests that it may be unnecessary for patients using rapid-acting insulin to have five smaller meals.