USE OF UNCOOKED CORNSTARCH TO AVERT NOCTURNAL HYPOGLYCEMIA IN CHILDREN AND ADOLESCENTS WITH TYPE-I DIABETES

Intensive management of type I diabetes mellitus may lead to a signifi cant increase in hypoglycemia. This study evaluated the use of uncooke d cornstarch to avert hypoglycemia in 13 patients, ages 3.0-17.5 years , with diabetes and a history of nighttime hypoglycemia. The usual bed time snack (Standard Snack Period) was given for 14 days followed by 1 4 days in which 25%-50% of the carbohydrate content was given as uncoo ked cornstarch in milk (Test Snack Period). Blood glucose levels were obtained at 0200 and before breakfast during the 28-day study. No diff erence was found between the mean (+/- SD) before breakfast blood gluc ose levels during the two periods; however, the mean (+/- SD) number o f hypoglycemic episodes (blood glucose < 60 mg/dL or 3.3 mmol/L) was r educed significantly during the Test Snack Period at both 0200 (p < 0. 025) and before breakfast (p < 0.01) compared to Standard Snack Period (Standard Snack 2.00 +/- 2.12 versus Test Snack 0.61 +/- 0.87 at 0200 , Standard Snack 2.61 +/- 2.25 versus Test Snack 0.69 +/- 1.03 before breakfast). In addition, in four children who were evaluated with ever y-2-h glucose levels through the night, stable glycemia was achieved a fter cornstarch ingestion. Our results suggest that uncooked cornstarc h may be useful to decrease the frequency of nocturnal hypoglycemia in type I diabetes patients. This low-cost, simple intervention might be considered as an adjunctive therapy to diminish the risk of intensive diabetes management.