Eur J Pediatr (1995) 154 : 353-355 9 Springer-Verlag 1995 R. Birnbacher T. Waldh6r U. Schneider E. Schober Glycaemic responses to commonly ingested breakfasts in children with insulin-dependent diabetes mellitus Received: 14 June 1994 Accepeted: 16 December 1994 R. Bimbacher (r 9 U. Schneider E. Schober Paediatric Department, University Hospital of Vienna, W~ihringer Giirtel 18-20, A-1090 Vienna, Austria Tel.: 0043-1-40400-3232 Fax: 0043-1-40400-3238 T. Waldh6r Institute of Turnour Biology and Cancer Research, University of Vienna, Austria Abstract The glycaemic response to commonly ingested breakfast with different glycaemic index (corn- flakes, white bread, dark rye bread and muesli) was investigated in 14 children with insulin-dependent dia- betes mellitus. The blood glucose re- sponse after cornflakes was signifi- cantly higher than after the other breakfasts, whereas the areas under the blood glucose curve were not sta- tistically different. We observed no difference in blood glucose rise be- tween the other breakfast types. Key words Insulin-dependent diabetes 9 Children. Glycaemic index 9 Diet Abbreviations Gi glycaemic index 9 iDDM insulin-dependent diabetes mellitus Introduction Based on clinical experience the traditional diet for chil- dren with insulin-dependent diabetes mellitus (IDDM) prefers complex carbohydrates. Studies of the blood glu- cose level after ingestion of a large number of carbohy- drate-containing foods have been conducted defining their glycaemic index (GI) [5, 7]. Low GI high fibre diets re- sulted in improvement of metabolic control in diabetic adults [14], while in diabetic children data on high fibre diets are inconclusive [8]. Several reports have docu- mented that the intake of mono- and disaccarides does not have the expected impact on blood glucose rise [2, 3, 9, 12] even with a sucrose content up to 20% [10]. We in- vestigated the glycaemic response to commonly ingested breakfasts with different GI in 14 children with well con- trolled IDDM under normal daily conditions. Subjects and methods Fourteen children, 9 girls and 5 boys, with IDDM (mean age 12.8 + 1.4 years) participating in a diabetic summer camp fulfilled the fol- lowing criteria: volunteer, no variation of the daily insulin dosage > 1 IU, no medication except insulin, no variation in dietary car- bohydrate amount. The daily carbohydrate intake was 4.1 + 0.8 g/kg body weight, mean body mass index (BMI) in boys was 17.2 kg/ma, in girls 18.4 kg/m% All children used their ordinary insulin regimes with twice daily an individual mixture of normal and NPH insulin (dosage 0.8 + 0.2 IU/kg body weight/day). All children were used to three daily blood glucose measurements for self con- trol. The mean duration of the disease was 4.1 _+ 2.8 years, mean HbAlc was 7.3 _+0.5%. During 4 days the children received four different breakfasts, the composition of the other meals was similar for all children as well. The ingested breakfast had different GI, according to Jenkins et al. [7] white bread was taken as a reference standard with a GI of i00. Each volunteer consumed his/her normally prescribed amount of carbohydrates for breakfast (0.9 _+ 0.2 g/kg body weight), which was kept constant from days 1 to 4. Breakfast was taken at 0800 hours, after the first baseline blood glucose mea- surement. On the 1st day breakfast consisted of cornflakes (GI: 119 [7] with 250 ml of milk (GI:49), on the 2nd day the children ate white bread (GI: 100), on the 3rd day dark rye bread (GI: 95) both with a standardized amount of 10 g butter and 250 ml tea, and