Premeal insulin administration lowers postprandial blood glucose and increases myocardial microvascular blood flow in people with type 1 diabetes: a randomised, crossover clinical trial
Authors' conclusion
Appropriately timed premeal insulin led to lower postprandial blood glucose along with increased myocardial MBF in people with type 1 diabetes.
Study context
- Population
- People with T1D aged 18–35 years with BMI <30 kg/m², and matched control participantsT1D in both crossover protocols
- Participants
- 18 / 18 / 18
- Comparison
- Prandial insulin 15 min before vs 15 min after meal start in T1D; matched controls without exogenous insulin
- Premeal insulinn = 18
- Postmeal insulinn = 18reference
- Controln = 18
- Primary endpoint
- Change in myocardial MBF within each protocol
- Follow-up
- Baseline to 2 h after meal ingestion
Methodological detailsoutcome assessors masked to group assignment, age-, sex- and BMI-matched control participants
- Outcome assessors masked to group assignment
- Age-, sex- and BMI-matched control participants
Primary result
As reported in the abstract
Change in myocardial MBF · 2 h after meal
- Myocardial microvascular blood flow (MBF) increased with premeal insulin in T1D
- p=0.044
Further findings
| Outcome | P value |
|---|---|
| Glucose area under the curve (T1D)Postmeal insulin vs Premeal insulin · significantly greater with postmeal insulin | P = 0.015 |
Myocardial microvascular flow velocity (T1D)
- Significantly increased with premeal insulin
- P = 0.031
Safety
- Changes in vital signs were similar between all protocols
Original publication
Premeal insulin administration lowers postprandial blood glucose and increases myocardial microvascular blood flow in people with type 1 diabetes: a randomised, crossover clinical trial. Diabetologia. Published 11 July 2026. doi:10.
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