Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic Review Article Swipe
Enza Mozzillo
,
Roberto Franceschi
,
Francesca Di Candia
,
Alessia Ricci
,
Letizia Leonardi
,
Martina Girardi
,
Francesco Maria Rosanio
,
M. Loredana Marcovecchio
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3390/jpm12122058
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3390/jpm12122058
The aim of this systematic review was to report the evidence on optimal prandial timing of insulin bolus in youths with type 1 diabetes. A systematic search was performed including studies published in the last 20 years (2002–2022). A PICOS framework was used in the selection process and evidence was assessed using the GRADE system. Up to one third of children and adolescents with type 1 diabetes injected rapid-acting insulin analogues after a meal. Moderate–high level quality studies showed that a pre-meal bolus compared with a bolus given at the start or after the meal was associated with a lower peak blood glucose after one to two hours, particularly after breakfast, as well as with reduced HbA1c, without any difference in the frequency of hypoglycemia. There were no differences related to the timing of bolus in total daily insulin and BMI, although these results were based on a single study. Data on individuals’ treatment satisfaction were limited but did not show any effect of timing of bolus on quality of life. In addition, post-prandial administration of fast-acting analogues was superior to rapid-acting analogues on post-prandial glycemia. There was no evidence for any difference in outcomes related to the timing of insulin bolus across age groups in the two studies. In conclusion, prandial insulin injected before a meal, particularly at breakfast, provides better post-prandial glycemia and HbA1c without increasing the risk of hypoglycemia, and without affecting total daily insulin dose and BMI. For young children who often have variable eating behaviors, fast-acting analogues administered at mealtime or post-meal could provide an additional advantage.
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Concepts
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.3390/jpm12122058
- https://www.mdpi.com/2075-4426/12/12/2058/pdf?version=1671517042
- OA Status
- gold
- Cited By
- 8
- References
- 27
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4311366651
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4311366651Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/jpm12122058Digital Object Identifier
- Title
-
Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic ReviewWork title
- Type
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reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2022Year of publication
- Publication date
-
2022-12-13Full publication date if available
- Authors
-
Enza Mozzillo, Roberto Franceschi, Francesca Di Candia, Alessia Ricci, Letizia Leonardi, Martina Girardi, Francesco Maria Rosanio, M. Loredana MarcovecchioList of authors in order
- Landing page
-
https://doi.org/10.3390/jpm12122058Publisher landing page
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https://www.mdpi.com/2075-4426/12/12/2058/pdf?version=1671517042Direct link to full text PDF
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YesWhether a free full text is available
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-
goldOpen access status per OpenAlex
- OA URL
-
https://www.mdpi.com/2075-4426/12/12/2058/pdf?version=1671517042Direct OA link when available
- Concepts
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Medicine, Bolus (digestion), Insulin, Hypoglycemia, Post-prandial, Type 1 diabetes, Meal, Diabetes mellitus, Type 2 diabetes, Internal medicine, EndocrinologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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8Total citation count in OpenAlex
- Citations by year (recent)
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2025: 2, 2024: 4, 2023: 2Per-year citation counts (last 5 years)
- References (count)
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27Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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