COMPARISON OF THE ABILITY OF BREAD VERSUS BREAD PLUS MEAT TO TREAT AND PREVENT SUBSEQUENT HYPOGLYCEMIA IN PATIENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS

We sought to determine whether treatment of hypoglycemia with a snack containing both protein and carbohydrate results in more prolonged pro tection against subsequent hypoglycemia than ingestion of carbohydrate alone. We studied six insulin-dependent diabetic subjects on two occa sions. On both occasions subjects received a variable overnight insuli n infusion to achieve euglycemia followed by a constant insulin infusi on(similar to 0.5 mU . kg(-1). min(-1)) designed to produce hypoglycem ia. When glucose reached 50 mg/dL, subjects were fed a snack consistin g of either bread (similar to 85 kcal) or bread plus meat (similar to 205 kcal). Both contained 15 g of carbohydrate. The insulin infusion w as continued for the next 3 h or until glucose again fell to 50 mg/dL. Although bread plus meat resulted in a more marked rise (P < 0.05) in glucagon than did bread alone, neither the post treatment peak glucos e concentration (73 +/- 4 us. 70 +/- 6 mg/dL) nor the subsequent rate of fall of glucose (-0.42 +/- 0.10 vs. -0.35 +/- 0.07 mg/dL/min) diffe red. The present study shows that the rate of redevelopment of hypogly cemia does not differ after eating bread or bread plus meat. Therefore treatment of hypoglycemia with a protein-enriched snack merely adds c alories rather prolonged protection against subsequent hypoglycemia.