COMPLEX CARBOHYDRATES IN THE PREVENTION OF NOCTURNAL HYPOGLYCEMIA IN DIABETIC CHILDREN

In order to prevent nocturnal hypoglycaemia in patients with insulin-dependent diabetes mellitus with complex carbohydrates a pilot-study was designed with nine children with ages of 9-18 years. The children were admitted twice to the hospital (control and test) and remained the evening, night and morning the following day. The standard evening snack, given on the control day, was replaced on the test day by a test snack which contained a solution of uncooked cornstarch as a source of complex carbohydrates. The carbohydrate content of the test snack was maintained but did not contain mono- and disaccharides. Blood samples were collected and when the child had blood glucose concentrations of less-than-or-equal-to 3.0 mmol/l or showed clinical symptoms of impending hypoglyaemia, intervention occurred with extra carbohydrates. Six out of nine children needed intervention after the standard snack (blood glucose concentrations were 1.8, 2.7, 3.0, 3.6 and 3.7 mmol/l). After the test snack this was four out of nine (blood glucose concentrations were 2.3, 2.6, 3.2 and 3.2). Three children needed a second intervention after the standard snack versus two after the test snack. One child needed a third intervention after the standard snack. The time of intervention ranged from 11 p.m. to 4 a.m. and from 10 p.m. to 12 a.m., respectively, on the day of the standard and test snack. Raw cornstarch, as a source of complex carbohydrates, did not prevent nocturnal hypoglycaemia in the dose used but blood glucose levels dropped more slowly than those after the standard snack. A combination of complex and semi-complex carbohydrates in the last evening snack or meal might be effective for the prevention of nocturnal hypoglycaemia.