A high-fat meal increases the postprandial glucose levels and insulin requirements of patients with type 1 diabetes, according to research published online in Diabetes Care.
Howard A. Wolpert, MD, of the Joslin Diabetes Center in Boston, and colleagues conducted a crossover study that compared glucose control during two 18-hour periods after either a high-fat dinner (60 g) or a low-fat dinner (10 g) with identical carbohydrate and protein content. The protocol was completed by seven patients with type 1 diabetes.
Although considerable interindividual differences were noted, the researchers found that significantly more insulin units were required after a high-fat rather than low-fat dinner (12.6 vs. 9.0 units). However, even with additional insulin units, the high-fat meal caused more hyperglycemia. For a high-fat dinner, the carbohydrate-to-insulin ratio was significantly lower.
“The evidence from this study that dietary fat can cause postprandial hyperglycemia in some individuals with type 1 diabetes highlights the limitations of the current carbohydrate-based approach to bolus dose calculation that is widely used in intensive diabetes management,” the investigators noted. “Further studies are needed to develop and validate alternative insulin dosing algorithms for higher-fat meals, and to define new nutritional approaches for minimizing hyperglycemia induced by dietary fat.”