P-474: Beyond carbohydrate counting: inter-individual variability in postprandial glycemic responses in children with type 1 diabetes
V R, M DhingraAbstract
Introduction
Carbohydrate counting forms the basis of insulin dosing in children with type 1 diabetes. However, in day-to-day practice, similar meals often result in different postprandial glucose responses, suggesting that factors beyond carbohydrate content may be involved.
Objectives
To examine variability in postprandial glycemic responses to comparable meals and to assess whether individual response patterns remain consistent
Methods
Fifty children with type 1 diabetes consumed comparable meals on multiple occasions. Continuous glucose monitoring data were reviewed for peak glucose, time to peak, and overall glycemic excursions. Variability between individuals was assessed, and responses within the same individual were compared across repeated exposures.
Results
Considerable variability was seen between individuals, with peak glucose differences of up to 62 mg/dL following similar meals. Some children showed early sharp rises in glucose, while others had more delayed and prolonged excursions. Within individuals, however, response patterns were relatively consistent across repeated exposures. These differences were not fully explained by carbohydrate intake or insulin dosing.
Conclusions
Postprandial glycemic responses in children with type 1 diabetes vary between individuals but tend to follow consistent patterns within the same individual. This suggests that carbohydrate counting alone may not fully capture glycemic response, and that more individualized approaches to insulin dosing may be needed.