Recently, we demonstrated that spaghetti caused a significantly lower glycemic response in isoinsulinemic insulin-dependent diabetic (IDDM) subjects than an exchangeable amount of potato. The question is, however, whether the difference of the glucose response in IDDM patients is preserved if these carbohydrate-rich foods are taken as part of a mixed meal. To answer this question, we evaluated blood glucose, free-insulin, and glucagon responses to exchangeable amounts of spaghetti and potato when ingested together with bolognese sauce in seven IDDM patients who had attained euglycemia with the artificial pancreas before meal intake. The potato (200 g raw wt) with bolognese sauce (167 g) and spaghetti (50 g raw wt) with bolognese sauce (167 g) had ∼ identical caloric content (435 and 447 kcal, respectively), fat (18 g each), protein (23 and 26 g, respectively), and carbohydrate (47 and 48 g, respectively). Blood glucose increment after white spaghetti and bolognese sauce was only ∼ 50% of that seen in response to potato and bolognese sauce. Similar constant insulin levels and increments in glucagon were seen. A major determinant of the postmeal glucose rise in IDDM patients seems to be dependent on the kind of carbohydrate in the meal. The approach by which the insulinemia was kept constant by the artificial pancreas seems to be a valuable tool for studying glycemic responses to different meals in IDDM patients who otherwise show great variations in circulating insulin and glucose levels when treated by subcutaneously administered insulin.

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