الفهرس 
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Abstract
A primary focus in the management of type 1 diabetes is to match prandial insulin doses with meal carbohydrate quantity. However, despite patients’ best efforts, carbohydrate counting (CC) alone may not result in optimal blood glucose control.
Glycemic index usage along with the total carbohydrate amount can provide additional benefit in optimizing prandial glycemic response in type 1 diabetic patients.
The aim of the current study was to evaluate feasibility and effectiveness on short term blood glucose control of using glycaemic load counting (GLC) versus carbohydrate counting (CC) for prandial insulin dosing in patients with type 1 diabetes (T1DM) treated by insulin pump.
The present study is a Cross over randomized interventional study including 15 patients with type 1 diabetes regularly following up at the Paediatric and Adolescent Diabetes Unit (PADU), Paediatrics Hospital, Ain Shams University in the period from September 2022 till March 2023. The patients received the same breakfast meal, which was prepared similarly in all studied patients. Sequence, quality and amounts of meals consumed during the first week of the study were replicated during the second week. Prandial insulin doses were calculated using one regimen for 1 week and the other regimen for the subsequent week.
Data from the current study showed that postprandial glycemic response tended to be more favourable during the GLC period than during the CC period. Blood glucose postprandial excursions was significantly lower during the GLC than the CC period from baseline to 120 min (p = <0.001), baseline to 180 min (p = <0.001) and baseline to 240 min (p = 0.007). However, there was no postprandial glucose difference between the two periods from baseline to 60 min (p = 0.083).
This study reveals the importance of depending on glycemic load in determining premeal insulin doses to achieve better glycemic control in patients with type 1 diabetes. Controlling postprandial glycemic excursion is crucial in management of type 1 diabetes as glycemic variability has been linked with vascular complications.