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Updated: Sep 18, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Impact of Meal Carbohydrate Content on Postprandial Hyperglycemia During Inpatient Use of Fully Automated Insulin
Gabija Krutkyte1,2,3, Nicolas Banholzer4, David Herzig1
1Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Abstract:
In this study, we aimed to explore the impact of meal carbohydrate (CHO) content on postprandial hyperglycemia in hospitalized patients receiving fully automated insulin delivery (AID). We performed a post-hoc analysis of two trials and analyzed 844 postprandial periods from 48 adults treated with fully AID (FlorenceD2W-T2 or CamAPS HX) in hospital using generalized additive regression models. Meal CHO content had a nonlinear effect on postprandial hyperglycemia risk (P < 0.001). Postprandial hyperglycemia was more likely at breakfast compared with lunch and dinner (odds ratio or OR [95% confidence interval or CI] 1.8 [1.2, 2.6], P = 0.006; and 1.5 [1.1, 2.2], P = 0.05, respectively) and more frequent on days with glucocorticoid administration (OR [95% CI] 3.3 [2.1, 5.1]; P < 0.001). In conclusion, during fully AID in hospitalized patients, the risk of postprandial hyperglycemia remained <50% for meals ≤50 g CHO. The CHO tolerance was lowest at breakfast and with concomitant glucocorticoid therapy across all meals.
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