Food cravings during acute hypoglycaemia in adults with Type 1 diabetes

Background: Food craving is defined as an intense desire to eat a specific foodstuff. It may be distinguished from the sensation of hunger, which is relieved by nonspecific foodstuffs. No controlled studies have examined the effects of hypoglycaemia on food cravings. Thus, the aim of this study was to examine change in cravings for eight specified food types during euglycaemia and insulin-induced hypoglycaemia. Methods: Thirteen adults with Type 1 diabetes attended two experimental sessions where acute hypoglycacmia was induced with either insulin aspart or human soluble insulin. Food cravings were assessed, using a questionnaire, at baseline and at the onset of the autonomic reaction to hypoglycaemia ("R"). Results: The mean arterialised blood glucose concentration at baseline was 6.0 +/- 0.3 mmol l(-1) and at R was 1.9 +/- 0.4 mmol l(-1) (P < .01). Fifteen percent of subjects reported having a craving for food during euglycaemia. The prevalence increased to 65% during hypoglycaemia (P < .01). Cravings for seven of the eight food types increased during hypoglycaemia, but the greatest effect sizes (> 1.0 standard deviations) were observed for three food types that had a high carbohydrate content. Conclusions: In people with Type 1 diabetes, acute hypoglycaemia produces a highly reliable generalised increase in cravings for food, particularly foodstuffs with a high content of carbohydrate. The mechanisms behind this response remain to be elicited. (C) 2004 Elsevier Inc. All rights reserved.