Lifestyle, Mediterranean diet and insulin therapy
DISCUSSION Compliance with the diet is critical to achieving and maintaining a good result, and is based on several factors; the choice of a diet very close to the habits of patients and the whole family, can lead to greater diet adherence over time. It is also important not to underestimate the interval of time between meals which is about 7 hours in the lifestyles of our population. herefore, the food model dictates the choice of glucose-lowering therapy, and especially the choice of the type of Insulin, because of the different kinetic behavior of the various types of Insulin. The mode of action of biphasic Insulin Aspart 70/30Â features intermediate characteristics between the ones of synthetic Insulin and regular human Insulin, with a peak of action that comes close to that of the rapid acting one, Â but with a longer duration of action, thanks to the presence of a 30% component with delayed action. These features suggest that the biphasic Insulin Aspart would find its optimal use in situations where, for example, the interval of time between meals is prolonged, and the diet includes a dietary consumption of food with high glucose content, as in a typical Mediterranean diet. This type of Insulin allows the containment of excessive excursion of post-prandial glycemia, and, at the same time, the maintenance of glycemic control between meals. REFERENCES 1. International Diabetes Federation (IDF), Guidelines for Management of Postmeal Glucose 2007 – page 20; Source: www.idf.org / Webdata / docs / Guideline_PMG_final.pdf 2. Biesalski HK, Diabetes preventive components in Mediterranean diet, Eur J Nutr, 2004, Suppl. 1.43: 1/26-1/30 3. Riccardi G et al, Nutrition Reviews, vol.61 No. 5, May 2003: (II) S56-S60 4. Garber AJ et al, Attainment of Glycemic goals in type 2 diabetes with once, twice or thrice-daily dosing with biphasic insulin aspart 70/30.Diab.Ob. Metab 2006,8:56-66 5. Rave et al: fifferent preparations premelangees of insulin aspart biphasique sont par des caracterisees differences notables en termes de Delai and hard of actio. Alfediam March 2007 6. Monnier L et al: Contributions of anf postaprandial fasting plasma glucose increments to the overall diurnal hiperglycemia of TUPE 2 diabetic patients.Diab.Care 2003,26:881-885 7. Cristainsen JS: insulin aspart rapid control for postmeal glucose excursion.Expert Rev. Endoc.Metab. 2007.2 :587-97
Amodio Botta
UOSD Dietologia, Nutrizione Clinica e Malattie Metaboliche — AORN S.G. Moscati — Avellino
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