الفهرس 
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Abstract
S
UMMARY
ontinuous Subcutaneous Insulin Infusion (CSII) is almost the closest method to the physiological secretion of insulin among patients with type 1 diabetes. The use of CSII can provide the family with greater security and children and adolescents have more autonomy in relation to the treatment of T1DM.
Major dietary macronutrients including fat, protein and carbohydrates with its glycemic index affect glucose insulin homeostasis. The primary determinant affecting mealtime insulin dosage in T1DM is carbohydrate which has direct influence on postprandial glucose level.
Although Insulin pump offers different boluses to tailor insulin delivery according to meal composition, yet there is lack of effective and satisfactory solutions concerning insulin dose adjustment to cover the h-GI meal.
The aim of the current study is to evaluate the safety and efficacy of different meal time insulin dosage and regimens in optimizing post-prandial glucose excursion following consumption of high glycemic index meals. Twenty four patients with T1D were enrolled in this randomized controlled trial conducted at Pediatric and Adolescent Diabetes Unit (PADU) at Ain Shams University Hospitals.
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Summary
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Our study found that standard bolus delivered 25-30 min before the meal successfully controlled postprandial glucose response with no risk of hypoglycemia. Furthermore, our study demonstrated the superiority of the super bolus in controlling postprandial glucose excursion, whereas it offers the participants tight glycemic control without increasing the risk of hypoglycemia.
Achieving a target postprandial glucose response is important because postprandial hyperglycemia has been identified as a risk factor for the development of long-term complications of diabetes.
This study has important implications for clinical practice and patient education and point to the need for research focused on the development of new insulin dosing algorithms based on meal composition especially the glycemic index of carbohydrates.