Abstract
Purpose
Oxidative stress is closely related to type 1 diabetes mellitus (T1DM), playing a key role in the pathogenesis of the disease and progression of complications. It is characterized by loss of equilibrium between oxidative factors and antioxidant protective mechanisms. Several markers have been used to assess both components of oxidative status; two of which are malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP).
Methods
We investigated glycated hemoglobin (HbA1c), lipid profile, MDA, and FRAP in 35 patients with T1DM, aged 2–23 years, at the end of two 4-month observational periods: period A: standard insulin dosing per meal, and period B: proper prandial insulin dosing based on the amount of carbohydrates contained in each meal.
Results
At the end of period B, (i) glucose control (HbA1c) was improved; (ii) oxidative stress, estimated by MDA, showed a tendency to decrease; and (iii) antioxidant capacity, estimated by FRAP, was significantly increased compared with that of period A. No significant differences were observed in the lipid profile of the patients between the two periods.
Conclusion
Proper insulin dosing based on carbohydrate counting (CC) may have an impact on the antioxidant defensive mechanisms of patients with T1DM through the attainment of a better glycemic profile. There are also indications that it may reduce MDA, an important biomarker of oxidative stress and a significant mediator of complications in T1DM. Therefore, prompt dietetic intervention using CC as early as possible after the diagnosis of T1DM is important for achieving optimal glycemic control and improved oxidative status.
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Eirini Kostopoulou and Bessie Spiliotis: conceptualization
Fotini Lamari, Spyros Skiadopoulos, Ioanna Partsalaki, and Andrea Paola Rojas Gil: methodology
Eirini Kostopoulou and Bessie Spiliotis: formal analysis and investigation
Eirini Kostopoulou: writing—original draft preparation
Bessie Spiliotis, Ioanna Partsalaki, Spyros Skiadopoulos, Fotini Lamari, and Andrea Paola Rojas Gil: writing—review and editing
Bessie Spiliotis: supervision
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Committee of Ethics and Code of Conduct for Research of the University Hospital of Patras and with the 1964 Declaration of Helsinki and its later amendments, or comparable ethical standards. No reference number was needed for this specific data collection of the studied patients.
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Kostopoulou, E., Livada, I., Partsalaki, I. et al. The role of carbohydrate counting in glycemic control and oxidative stress in patients with type 1 diabetes mellitus (T1DM). Hormones 19, 433–438 (2020). https://doi.org/10.1007/s42000-020-00189-8
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DOI: https://doi.org/10.1007/s42000-020-00189-8