Nutritional management of children with insulin-dependent diabetes mellitus (IDDM) traditionally has emphasized the exclusion of sucrose because of concern that sucrose contributes to poorer blood glucose control. Our preliminary study in children with IDDM suggest that sucrose may be used in mixed meals without an adverse glycemic response when fasting blood glucose concentrations are higher than ideal. Recent data in adults suggest that dietary sucrose might have more of a glycemic effect if studied in subjects with euglycemic fasting levels of glucose. Thus, it is important to evaluate the glycemic effect of sucrose under euglycemic conditions, particularly since many children eat high sucrose snacks (sucrose sweetened beverages, chocolate bars) without other foods with starch, protein and fat that may buffer or modify the glycemic response. Definitive studies that evaluate the glycemic effect of high sucrose-containing snacks given without other foods are unavailable. The objective of this study in 12 children (8-17 years) with well controlled C-peptide negative IDDM is to compare the glycemic response of children to high sucrose-containing snacks given without other foods and to compare the glycemic effects of a solid versus a liquid high sucrose-containing snack. Children will be randomized in a crossover design to receive sucrose-free (Suc-Free, 3% kcal as sucrose) and sucrose- containing (Suc- Con, 10% sucrose) meal plans when fasting glucose concentrations are between 80-100 mg/dl. A Suc-Free meal plan will be given for one day; Suc-Con meal plans will be given for two days with either sucrose as a solid or sucrose as a liquid given at snacktime. Each diet will be isocaloric and have similar proportions of carbohydrate, protein and fat.
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