Meal-related insulin requirements.

Postprandial glycemia correlates with meal size in insulin dependent diabetic and nondiabetic persons. Decline in meal tolerance as the day progresses noted in nondiabetics does not occur in IDDM. Meal size correlates with insulin secretion in nondiabetics and amounts of insulin infused by an artificial endocrine pancreas to IDDM. There is no diurnal change in insulin secretion in nondiabetics or insulin infusion into IDDM but not amounts of insulin secretions by nondiabetics. Sequence of meal ingestion influenced amounts of insulin infused into IDDM. It is unclear to what extent variation in carbohydrate contribution or composition affect postprandial events. More precise quantitative measures of meal-related glucose behavior such as mean indices of meal excursions may be useful. CSII used in IDDM has been shown to normalize postprandial endogenous glucose production.