SEARCH · PubMed Health

Results for “Breakfast”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

PubMed1999

Effect of consumption of a ready-to-eat breakfast cereal containing inulin on the intestinal milieu and blood lipids in healthy male volunteers.

OBJECTIVE: To investigate the effect of a breakfast cereal containing inulin on blood lipids and colonic ecosystem in normolipidemic young men. SETTING: Department of Food Science and Microbiology,University of Milan, Italy. SUBJECTS: Twelve healthy male volunteers, age 23.3 +/- 0.5 y, body mass index (BMI) 25.7 +/- 1.2 kg/m2 (mean +/- s.e.m.). INTERVENTIONS: Subjects consumed daily, for three periods of four weeks, 50 g of a rice-based ready-to-eat cereal (placebo) and the same cereal containing 18% inulin (test) in substitution of their habitual breakfast, then returned to the habitual diet (wash-out). They followed no other dietary restrictions. RESULTS: No changes in body weight, dietary habits, faecal and bile acid output, faecal short-chain fatty acid (SCFA) and faecal pH, were observed at the end of each period, whereas plasma total cholesterol and triacylglycerols significantly decreased at the end of test period by 7.9 +/- 5.4 (P < 0.05) and 21.2 +/- 7.8% (P < 0.005) respectively. Meal glucose tolerance test (MTT) resulted in the same incremental area under the curve for both cereals (IAUC test 124 +/- 35; placebo 118 +/- 33 mmol x min/l, ns). Inulin markedly enhanced breath H2 excretion (IAUC test 280 +/- 40; placebo 78 +/- 26 ppm x h, P < 0.005), as well as faecal concentration of L-lactate. Total facultative anaerobes significantly decreased after test, and bifidobacteria increased after correction for total anaerobes (P < 0.05). Changes in blood lipids were negatively correlated with bifidobacteria counts and positively with secondary bile acid excretion (P < 0.05). CONCLUSIONS: Inulin seems to have a lipid lowering potential in normolipidemic men possibly mediated by mechanisms related to colonic fermentation.

Adult↗

PubMed2002

The effect of food on the pharmacokinetics of nifedipine in two slow release formulations: pronounced lag-time after a high fat breakfast.

AIMS: The aim of this study was to investigate the effect of concomitant food intake on the bioavailability of two nifedipine containing modified release dosage forms for once daily administration. The clinical study was performed to investigate the in vivo relevance of pH-dependent differences in the in vitro release properties of the two dosage forms. METHODS: This was a randomized, open, 4-way crossover study in 24 healthy, male subjects. Following an overnight fast of 12 h single doses of Adalat OROS or Slofedipine XL were administered either in the fasted state or immediately after a high fat American breakfast. Nifedipine plasma concentrations in samples obtained until 48 h after drug administration were determined using a validated LC-MS/MS method. Calculation of pharmacokinetic parameters was conducted model-independently. The two dosage forms as well as the two administration conditions were compared by calculating point estimates and 90% confidence intervals for the relevant pharmacokinetic parameters. In vitro dissolution tests were performed using a paddle apparatus 3 acc. USP, a pharmacopoeial dissolution system consisting of reciprocating cylinders in flat-bottomed glass vessels, with various buffer systems covering the entire physiological pH-range of the gastrointestinal tract. RESULTS: After fasted administration the extent of bioavailability of nifedipine as characterized by AUC(0,infinity) was slightly lower for Slofedipine XL compared with Adalat OROS with a point estimate of 82.3% primarily resulting from pronounced differences in nifedipine concentrations during the first 15 h after administration. Accordingly, maximum plasma concentrations were lower after administration of Slofedipine XL compared with Adalat OROS (point estimate: 84.3%). Under fed conditions the differences in bioavailability between the two products as characterized by the pharmacokinetic parameters AUC(0,tn) and Cmax were greater than after fasting conditions with point estimates of 69.6% and 81.0%, respectively. However, most striking was a pronounced delay in nifedipine absorption observed under fed conditions after administration of Slofedipine XL which resulted in lag-times of more than 15 h in 15 out of 24 subjects. Owing to this lag-time under fed conditions the relative bioavailability of nifedipine from Slofedipine XL compared with Adalat OROS was only 28% over the intended dosing interval of 24 h. CONCLUSIONS: In this study a dosage form-dependent food interaction was observed which, under fed conditions, resulted in pronounced differences in the relative bioavailability of nifedipine between Slofedipine XL and Adalat OROS over the intended dosing interval of 24 h. The delay in nifedipine absorption when Slofedipine XL is administered after a high-fat breakfast may be explained by the formulation properties. Slofedipine XL is an erosive tablet with an acid resistant coating whereas Adalat OROS is designed with an osmotic push-pull system. Under fed conditions drug from the single unit enteric coated dosage form exhibits a delayed absorption probably due to an extensively prolonged gastric residence time which does not allow drug release, on the other hand the osmotically driven push-pull system is not sensitive to concomitant food intake. The observed phenomenon might be of therapeutic relevance. For example a change from taking Slofedipine XL in the fed to the fasted state might result in increased systemic concentrations of nifedipine.

Administration, Oral↗

PubMed1998

Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease.

BACKGROUND: The Food and Drug Administration (FDA) has recommended that cereal-grain products be fortified with folic acid to prevent congenital neural-tube defects. Since folic acid supplementation reduces levels of plasma homocyst(e)ine, or plasma total homocysteine, which are frequently elevated in arterial occlusive disease, we hypothesized that folic acid fortification might reduce plasma homocyst(e)ine levels. METHODS: To test this hypothesis, we assessed the effects of breakfast cereals fortified with three levels of folic acid, and also containing the recommended dietary allowances of vitamins B6 and B12, in a randomized, double-blind, placebo-controlled, crossover trial in 75 men and women with coronary artery disease. RESULTS: Plasma folic acid increased and plasma homocyst(e)ine decreased proportionately with the folic acid content of the breakfast cereal. Cereal providing 127 microg of folic acid daily, approximating the increased daily intake that may result from the FDA's enrichment policy, increased plasma folic acid by 31 percent (P=0.045) but decreased plasma homocyst(e)ine by only 3.7 percent (P= 0.24). However, cereals providing 499 and 665 microg of folic acid daily increased plasma folic acid by 64.8 percent (P<0.001) and 105.7 percent (P=0.001), respectively, and decreased plasma homocyst(e)ine by 11.0 percent (P<0.001) and 14.0 percent (P=0.001), respectively. CONCLUSIONS: Cereal fortified with folic acid has the potential to increase plasma folic acid levels and reduce plasma homocyst(e)ine levels. Further clinical trials are required to determine whether folic acid fortification may prevent vascular disease. Until then, our results suggest that folic acid fortification at levels higher than that recommended by the FDA may be warranted.

Aged↗

PubMed1996

A new breakfast cereal containing guar gum reduces postprandial plasma glucose and insulin concentrations in normal-weight human subjects.

A new guar-containing wheatflake product was developed to assess its effect on carbohydrate tolerance in normal-weight, healthy subjects. The extruded wheatflake breakfast cereals containing 0 (control) or approximately 90 g guar gum/kg DM were fed to ten fasting, normal-weight, healthy subjects using a repeated measures design. The meals were similar in energy (approximately 1.8 MJ), available carbohydrate (78 g), protein (15 g) and fat (5.4 g) content. The guar gum content of the test meals was 6.3 g. Venous blood samples were taken fasting and at 15, 30, 45, 60, 90, 120, 150 and 240 min after commencing each breakfast and analysed for plasma glucose, insulin and C-peptide. The guar wheatflake meal produced a significant main effect for glucose and insulin at 0-60 min and 0-240 min time intervals respectively, but not for the C-peptide levels compared with the control meal. Significant reductions in postprandial glucose and insulin responses were seen following the guar wheatflake meal compared with the control meal at 15 and 60 min (glucose) and 15, 60, 90 and 120 min (insulin). The 60 and 120 min areas under the curve for glucose and insulin were significantly reduced by the guar gum meal, as was the 240 min area under the curve for insulin. Thus, it can be concluded that the use of a severe method of heat extrusion to produce guar wheatflakes does not diminish the physiological activity of the guar gum.

Adult↗

PubMed1996

Improved zinc and iron absorption from breakfast meals containing malted oats with reduced phytate content.

The absorption of Zn or Fe from breakfast meals containing oat porridge prepared from malted and soaked oats and a control porridge made from untreated oats was measured in human subjects. The effect on Zn and Fe absorption of reducing the phytate content of oat-porridge meals was examined in each subject by extrinsic labelling of porridge with 65Zn and of bread rolls with 55Fe and 59Fe, and measuring whole-body retention and the erythrocyte uptake of isotopes. Each experiment comprised nine to ten subjects. The absorption of Zn from malted-oat porridge with a phytate (inositol hexaphosphate) content of 107 mumol was 18.3%, and significantly higher (P < 0.05) than from the control porridge containing 432 mumol phytate (11.8%). Fe absorption from the meal containing malted-oat porridge with 107 mumol phytate (Expt 2) was also significantly improved (P < 0.05) compared with that from the meal containing control porridge with 437 mumol phytate. The average increase in Fe absorption was 47%, or from 4.4 to 6.0%. In the breakfast meal containing malted porridge with 198 mumol phytate (Expt 3) the increase in Fe absorption was not significantly improved. Even though the phytate content was reduced to a greater extent in Expt 3 than Expt 2, the average increase in Fe absorption in Expt 3 was only 25% more than that from the meal containing control porridge (with 599 mumol phytate), depending on the higher absolute amount of phytate. In conclusion, an improvement in Zn and Fe absorption from oat products can be achieved by practising malting and soaking in the processing of oats. This may be of importance in the prevention of mineral deficiency in vulnerable groups.

Adult↗

PubMed2005

The influence of the glycaemic index of breakfast and lunch on substrate utilisation during the postprandial periods and subsequent exercise.

The present study investigated the effects of mixed high-carbohydrate (CHO) meals (breakfast and lunch) with different glycaemic indices (GI) on substrate metabolism during rest throughout the postprandial periods and during subsequent exercise. Nine recreationally active males completed two trials, high glycaemic index (HGI) and low glycaemic index (LGI), separated by 7 d in a randomised crossover design. In each trial, participants consumed breakfast and lunch, both of which were followed by a 3 h resting postprandial period. Following this, participants completed a 60 min run at 70 % of V O2max. The plasma glucose and serum insulin concentrations following both meals were significantly higher in the HGI trial than in the LGI trial (P<0.05). Serum insulin concentrations remained higher throughout the postprandial period following lunch in the HGI trial compared with the LGI trial (P<0.05). The total amount of fat oxidised was higher during the 3 h rest following lunch in the LGI trial than in the HGI trial (P<0.01) and subsequently CHO oxidation was lower (P<0.005). No significant differences in substrate utilisation were observed throughout the subsequent run. At 45 and 60 min, plasma glucose concentrations were higher in the LGI trial v. the HGI trial (P<0.05). The results of the present study provide further support that the GI concept can be successfully applied to mixed meals. The results also suggest that meals composed of LGI CHO may be more beneficial for maintaining a favourable metabolic milieu during the postprandial periods. Furthermore, during subsequent exercise, plasma glucose concentrations were better maintained following the LGI CHO meals.

Adult↗

PubMed2000

Potential of wheat-based breakfast cereals as a source of dietary antioxidants.

Whole wheat- and wheat bran-based ready-to-eat breakfast cereals could be important sources of dietary antioxidants. Of the antioxidants in wheat, free and esterified phenolic acids seem to have the greatest potential to be beneficial to health. Phenolic acids from breakfast cereals possess strong antioxidant activity in vitro at concentrations that would be obtained from a normal serving of whole wheat cereal. In addition, acid conditions and enzymic hydrolysis increase the solubility and activity of wheat phenolics suggesting that the digestive process could be important in altering the antioxidant potential of wheat-based foods. Current research on the antioxidant activity of wheat phenolics suggests that further research is warranted to determine the potential benefits of these dietary antioxidants. In addition, identification of both biological (e.g. digestion) and food processing conditions that impact the distribution, stability and activity of wheat antioxidants is needed in order to be able to produce food products with maximum health benefits.

Antioxidants↗

PubMed2006

The contribution of ready-to-eat cereals to daily nutrient intake and breakfast quality in a Mediterranean setting.

OBJECTIVES: To examine if and how ready-to-eat cereals (RTEC) contribute to the quality of the diet of children, adolescents and young adults in a Mediterranean setting. METHODS: A random sample of 3534 subjects aged 2 to 24 years in Spain was studied. Food and nutrient intakes were determined by a 24 hour recall. RTEC consumption was assessed by a quantitative food frequency questionnaire. Additional questions on socioeconomic level and nutritional knowledge were administered. Cereal consumption was classified into non-consumers and daily intakes between 1 and 20g, 21 and 40g, and more than 40g. After excluding the underreporters the final sample consisted of 2852 individuals. RESULTS: About half of the population (49.8%) reported eating RTEC. Macronutrient profile improved with increasing cereal consumption. Intakes of thiamine, riboflavin and vitamin B6 increased significantly with increasing consumption of RTEC in all age-sex groups, whereas niacin and folate intake improved in almost all groups and calcium, iron and vitamin D in at least half of the groups. Except for magnesium, vitamin B12 and vitamin E in males, consumption of RTEC was significantly associated with increased coverage of the daily nutrient requirements for all micronutrients studied. Higher levels of RTEC consumption was associated with a greater consumption of dairy products, and related to better breakfast quality. CONCLUSIONS: Level of RTEC consumption is associated with a better nutritional profile in the diets of Spanish children, adolescents and young adults and a lower risk for inadequate micronutrient intakes. RTEC consumers have better quality breakfasts, in terms of both food choices as well as energy and nutrient content.

Adolescent↗

PubMed2002

Prevalence of daily breakfast intake, iron deficiency anaemia and awareness of being anaemic among Saudi school students.

Iron deficiency anaemia is one of most prevalent nutritional disorders worldwide. It is known to affect the health and cognitive ability of children and adolescents. Studies in Saudi Arabia concentrate only on the population of young children and pregnant females or girls. Studies on the whole school student population is lacking. The objectives of this study were to identify the nutritional habits and the prevalence of anaemia among school students in Jeddah, as well as to recognize the students' awareness of their anaemic nutritional status. Data were collected from a sample of Saudi school children in Jeddah City from 42 boys' and 42 girls' schools during the month of April 2000. Data collection was done by an in-person interview to collect socio-demographic factors, nutritional habits, weight and height. Haemoglobin was measured in a sample of 800 students selected at random from both genders and different age groups. Anaemia was defined according to the new WHO cut-off levels for haemoglobin as: blood haemoglobin <11.5 g/dl for the 5-11 years boys and girls; <12.0 g/dl for 12-14 years boys and girls; <12.0 g/dl for 15+ girls and <13.0 g/dl for 15+ years boys. Proportion and 95% confidence intervals (CI) were calculated and significance was considered when the 95% CI did not overlap. Anaemia was reported among 20.5% of school students. Anaemia was more prevalent among students of at least 12 years as compared to the younger age group. Also, anaemia was more marked among governmental school attendees and those born to low-educated mothers. Menstruating girls were at around double the risk of being anaemic than non-menstruating girls. Anaemia was associated with negative impact on school performance and was more marked among those who failed their exams as compared to students with excellent results. Skipping breakfast was reported by 14.9% of students and this habit did not differ by age, sex, body mass index or social class. Skipping breakfast was more marked among students with poor school performance as compared to those with very good or excellent results. Only 34.1% of anaemic school students were aware of being anaemic. Awareness was nearly equal in all age groups and social classes but girls were more aware of their anaemic status than boys. Iron deficiency anaemia appears to be prevalent among school students. At age 12 years and over, low social class and menstruating girls constitute the high-risk groups. Screening is recommended for high-risk groups and school health programs are crucial to improve students' nutritional habits, knowledge and awareness.

Adolescent↗

PubMed1991

Influence of breakfasts with different nutrient contents on glucose, C peptide, insulin, glucagon, triglycerides, and GIP in non-insulin-dependent diabetics.

To examine the influence of coingestion of fat and protein in a mixed meal on carbohydrate metabolism, subjects with non-insulin-dependent diabetes mellitus (NIDDM) received three different breakfasts varying in the amount of fat and protein (group 1) or only in the amount of fat (group 2). Compared with the changes after a standard breakfast, insulin increased after the protein-rich meal and decreased after the fat-rich meal in group 1. Glucose and gastric inhibitory polypeptide (GIP) remained constant. In contrast, only GIP showed a significant increase after a high-fat meal in group 2. Thus, in NIDDM subjects, glucose and insulin responses to different mixed meals do not appear to be exclusively mediated by GIP. Protein was confirmed as a potent stimulator of insulin secretion. Other factors, such as an altered beta-cell response in diabetics to GIP or other incretions, must be considered to explain the reported results.

Aged↗

PubMed1995

Participation in the National School Lunch Program and the School Breakfast Program.

This paper uses student-level data from the School Nutrition Dietary Assessment Study to examine participation in the National School Lunch Program (NSLP) and the School Breakfast Program (SBP). Among students attending schools offering the relevant program, the NSLP participation rate is 56% and the SBP participation rate is 19%. Students who are certified for free or reduced-price meals are more likely than noncertified students to participate in either program. Among noncertified students, participation is negatively related to meal price. NSLP participation is less likely when the lunch offered contains < 32% of food energy from fat, suggesting that policies designed to drastically reduce the fat in NSLP lunches would also reduce participation. However, the fat content could be reduced somewhat below its current mean amount of 38% of food energy without affecting participation. Finally, the availability of the SBP does not appear to influence the likelihood of students eating breakfast.

Adolescent↗

PubMed1998

When science and politics listen to each other: good prospects from a new school breakfast program in Peru.

This article provides an overview of a school breakfast program implemented in 1993 in the Peruvian Andes. The program, designed by the Instituto de Investigación Nutricional in Lima and supported by the government of Peru, constitutes a clear departure from previous school feeding programs, which were heavily politicized and poorly documented. From the program's inception, nutritionists, managers, and social scientists have collaborated to produce a sound nutritional design, efficient distribution mechanisms, and effective evaluation methods. During the program's first year, controlled evaluations conducted in several Andean regions documented improved dietary intake and a significant decline in the prevalence of anemia. An educational evaluation also found improved verbal skills, higher school attendance, and lower dropout rates among recipients of the school breakfast. The results have prompted the Peruvian government to continue supporting the program, thus setting a new standard for the effective management of social expenditure in the context of economic adjustment.

Anemia↗

PubMed2001

Improving iron absorption from a Peruvian school breakfast meal by adding ascorbic acid or Na2EDTA.

BACKGROUND: Iron-fortified school breakfasts have been introduced in Peru to combat childhood iron deficiency. OBJECTIVE: We evaluated whether iron absorption from a school breakfast meal was improved by increasing the ascorbic acid content or by adding an alternative enhancer of iron absorption, Na2EDTA. DESIGN: In a crossover design, iron absorption from test meals was evaluated by erythrocyte incorporation of 58Fe and 57Fe. The test meals (wheat bread and a drink containing cereal, milk, and soy) contained 14 mg added Fe (as ferrous sulfate) including 2.0-2.6 mg 58Fe or 4.0-7.0 mg 57Fe. RESULTS: Geometric mean iron absorption increased significantly from 5.1% to 8.2% after the molar ratio of ascorbic acid to fortification iron was increased from 0.6:1 to 1.6:1 (P < 0.01; n = 9). Geometric mean iron absorption increased significantly from 2.9% to 3.8%, from 2.2% to 3.5%, and from 2.4% to 3.7% after addition of Na2EDTA at molar ratios relative to fortification iron of 0.3:1, 0.7:1, and 1:1, respectively, compared with test meals containing no added enhancers (P < 0.01; n = 10 for all). Iron absorption after addition of ascorbic acid (molar ratio 0.6:1) was not significantly different from that after addition of Na2EDTA (molar ratio 0.7:1). CONCLUSIONS: Ascorbic acid and Na2EDTA did not differ significantly in their enhancing effects on iron absorption at molar ratios of 0.6:1 to 0.7:1 relative to fortification iron. Additional ascorbic acid (molar ratio 1.6:1) increased iron absorption significantly. Increasing the molar ratio of Na2EDTA to fortification iron from 0.3:1 to 1:1 had no effect on iron absorption.

Anemia, Iron-Deficiency↗

PubMed2004

The Importance of Breakfast Consumption to Nutrition of Children, Adolescents, and Young Adults.

Breakfast consumption has been identified as an important factor in nutrition, especially during growth stages. This article discusses data from nearly 2,500 children, adolescents, and young adults in Louisiana and considers the impact of breakfast consumption on their nutritional well-being.

Journal Article↗

PubMed1989

Acute effect of protein or carbohydrate breakfasts on human cerebrospinal fluid monoamine precursor and metabolite levels.

Patients with normal pressure hydrocephalus who had three lumbar punctures during 1 week ingested either water, a protein breakfast, or a carbohydrate breakfast 2.5 h before each of the lumbar punctures. The CSF was analyzed for biogenic amine precursors and metabolites. The protein meal raised CSF tyrosine levels, a finding consistent with animal data, but did not alter those of tryptophan or any of the biogenic amine metabolites. The carbohydrate meal increased CSF 3-methoxy-4-hydroxyphenylethylene glycol, an unexplained finding. The carbohydrate meal did not affect CSF tryptophan, tyrosine, 5-hydroxyindoleacetic acid, or homovanillic acid. Our results support the idea that in humans protein or carbohydrate meals do not alter plasma amino acid levels sufficiently to cause appreciable changes in CNS tryptophan levels or 5-hydroxytryptamine synthesis.

Dietary Carbohydrates↗

PubMed1981

Lack of effect of pancreatic polypeptide in the rate of gastric emptying and gut hormone release during breakfast.

Bovine pancreatic polypeptide (PP) was infused intravenously in 5 healthy subjects on two separate occasions with mean doses of 1 and 2 pmol kg-1 min-1, respectively, which achieved plasma levels equal to and twice those observed after a normal mixed breakfast. The gastric emptying rate of a carbohydrate-rich breakfast 20 min after the start of each PP infusion was not significantly different from a control infusion of 0.15 M saline. PP is unlikely to be an important physiological modulator of gastric emptying rate in man.

Adult↗

PubMedDate not supplied

[Effect of a School Breakfast Program on the prevalence of obesity and cardiovascular risk factors in children].

OBJECTIVE: To determine the effect of a School Breakfast Program on obesity and some cardiovascular risk factors in 6 to 10 year old schoolchildren. MATERIAL AND METHODS: A quasi-experimental prospective study was conducted in 2002-2003, in 17 municipalities of Sonora State, Mexico. The intervention group consisted of 254 children participating in a School Breakfast Program (SBP group). The control group (NSBP group, n=106) included children who did not participate in the program. In both groups the body mass index for age (BMI/age) and body composition by electrical resistance using bioelectrical bioimpedance analysis (BIA) were estimated at the beginning and at the end of a 9-month period. In a subgroup of 264 school-children (SBP and NSBP children), serum cholesterol, triglycerides and fasting glucose were measured at the start and at the end of the program. RESULTS: The body mass index in the SBP and NSBP groups was not different at the start or at the end of the school period (p>0.05). The proportion of overweight and obese children and the percentage fat remained similar in both groups. However, the lean mass increased (p>0.05) at the end of the school period in both groups, and hence, cannot be attributed to the program. The biochemical parameters showed no change (p>0.05) in blood glucose, total serum cholesterol, and triglycerides in either group at the end of the school period. CONCLUSIONS: Study results showed no evidence of a negative effect of SBP in terms of risk factors for obesity and cardiovascular disease.

Body Composition↗

PubMed1991

Split-mixed insulin regimen with human ultralente before supper and NPH (isophane) before breakfast in children and adolescents with IDDM.

OBJECTIVE: Fasting hyperglycemia is common in patients with insulin-dependent diabetes mellitus (IDDM) treated with twice-daily subcutaneous insulin regimens. We postulated that substituting human ultralente insulin for the presupper dose of intermediate-acting insulin would improve overnight glycemic control in children and adolescents with IDDM. RESEARCH DESIGN AND METHODS: This 6-mo double-blind crossover study compared a conventional insulin regimen, a mixture of human NPH and regular given before both breakfast and supper (NPH), with a novel twice-daily regimen in which human ultralente replaced NPH before the evening meal (ultralente). This study was comprised of 20 children and adolescents (mean age and duration of IDDM 11.3 +/- 2.9 and 2.4 +/- 1.3 yr, respectively) from the Youth Clinic of the Joslin Diabetes Center, all of whom regularly performed self-monitoring of blood glucose (SMBG) and had been treated exclusively with human insulin (mean daily dose 0.75 +/- 0.22 U/kg). Subjects performed SMBG on a prescribed schedule with a glucose meter with an electronic memory, and recorded results of blood glucose measurements, insulin dosages, and episodes of hypoglycemia. Monthly measurements were obtained for height, weight, and HbA1, and mean daily insulin dosages and average blood glucose level before breakfast, lunch, supper, bedtime snack, and between 0200 and 0300 were calculated. Nonfasting serum lipids were measured at entry, crossover, and the end of the study. RESULTS: After 3 mo, mean HbA, did not differ significantly (9.1 +/- 1.7 vs. 9.5 +/- 1.4%, NPH and ultralente, respectively). Mean fasting blood glucose was significantly lower on ultralente (9.6 +/- 1.9 vs. 10.3 +/- 2.2 mM, P less than 0.05, and blood glucose showed a similar trend (0.05 less than P less than 0.1) before lunch (8.9 +/- 1.7 vs. 9.8 +/- 2.6 mM. Mean blood glucose before bedtime snack was significantly lower (P less than 0.01) on NPH (8.4 +/- 1.9 vs. 10.0 +/- 2.1 mM) but did not differ significantly before supper or between 0200 and 0300. On the two regimens, growth and serum lipids were normal and similar, and no differences were observed in the incidence or severity of hypoglycemia. CONCLUSIONS: Compared with a mixed dose of regular and NPH, a similar dose of a mixture of regular and human ultralente insulin before supper caused a modest reduction in fasting blood glucose levels but was associated with higher blood glucose levels before the bedtime snack. Overall glycemic control, reflected in HbA1 values, was not significantly improved.

Child↗