Submitted Successfully!
To reward your contribution, here is a gift for you: A free trial for our video production service.
Thank you for your contribution! You can also upload a video entry or images related to this topic.
Version Summary Created by Modification Content Size Created at Operation
1
Chiara Garonzi
 + 2419 word(s) 2419 2021-08-03 05:01:59

Video Upload Options

Do you have a full video?
Send video materials Upload full video

Confirm

Are you sure to Delete?
Yes No
Cite
If you have any further questions, please contact Encyclopedia Editorial Office.
Garonzi, C.; Forsander, G.; Maffeis, C. Fat intake and Glycemic Controltes. Encyclopedia. Available online: https://encyclopedia.pub/entry/15915 (accessed on 24 April 2024).
Garonzi C, Forsander G, Maffeis C. Fat intake and Glycemic Controltes. Encyclopedia. Available at: https://encyclopedia.pub/entry/15915. Accessed April 24, 2024.
Garonzi, Chiara, Gun Forsander, Claudio Maffeis. "Fat intake and Glycemic Controltes" Encyclopedia, https://encyclopedia.pub/entry/15915 (accessed April 24, 2024).
Garonzi, C., Forsander, G., & Maffeis, C. (2021, November 11). Fat intake and Glycemic Controltes. In Encyclopedia. https://encyclopedia.pub/entry/15915
Garonzi, Chiara, et al. "Fat intake and Glycemic Controltes." Encyclopedia. Web. 11 November, 2021.
Fat intake and Glycemic Controltes
Edit
This entry is adapted from the peer-reviewed paper 10.3390/nu13082625

Nutrition therapy is a cornerstone of type 1 diabetes management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. The specific role of macronutrients is still debated, particularly fat intake. 

fat intake diet nutrition type 1 diabetes glycemic control cardiovascular diseases

1. Introduction

Type 1 diabetes (T1D) is one of the most common chronic diseases of childhood [1][2]. Glycemic control, nutrition therapy and physical activity are the three cornerstones of T1D management. The main goals of the therapy are the maintenance of blood glucose within a proper range, close to normoglycaemia, with as low frequency of hypoglycemic and hyperglycemic episodes as possible, and reduction of macro- and micro-vascular complications [3][4][5][6].
Even though clinical manifestations of cardiovascular diseases (CVDs) generally appear in adulthood, the vascular damage might start early in T1D and evidence of subclinical CVD can be detected in adolescence [7]. In addition, youth affected by prediabetes or diabetes have an increased risk of metabolic disorders in adulthood, such as hypertension, dyslipidemia, and metabolic syndrome, predisposing to CVD [8]. Therefore, the prevention and early detection of cardiovascular risk factors are mandatory in young with T1D, as assessed in the American Diabetes Association (ADA) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines. Periodical screening and eventually proper treatment for hypertension, dyslipidemia, smoking and nephropathy are recommended [6][9].
The most important cardiovascular risk factor in T1D is glycemic control, also adjusting for potential confounders [10]. Glycemic control is affected by diet and, in particular, diet composition, which contributes to the development of complications in individuals with T1D [11]. Nevertheless, the specific role of the intake of different nutrients is still a matter of debate, in particular fat intake [12][13][14][15][16].

2. Nutrition Guidelines and Adherence in Children and Adolescents with T1D

Current dietary recommendations for people with diabetes reflect guidelines for healthy eating for the general population. The ADA and ISPAD guidelines for children and adolescents with diabetes underline the importance of an individualized assessment of nutrition therapy and the related best distribution of macronutrient, aiming at improving glycemic control and lower cardiovascular risk [4][6]. ISPAD recommendations give the following thresholds as a guide: carbohydrate intake should be 45–50% of total daily energy intake, fat intake no greater than 30–35% (saturated fat < 10%), and protein intake 15–20%. Energy intake should be appropriate for optimal growth in children and adolescents and keeping an ideal body weight. Diet should be assorted with healthy foods, such as fruits, vegetables, dairy, whole grains, legumes and lean meat. Thus, great emphasis is given to the quality of nutrients consumed. Healthy sources of carbohydrate foods, foods with high content of fibers, the replacement of saturated fat with polyunsaturated and monounsaturated fat and finally low-fat animal-derived and vegetable protein sources should be encouraged, according to current guidelines. Instead, restrictions in one macronutrient are discouraged, due to the risk of growth compromising and nutritional deficiencies [4].
Several studies from different countries demonstrated a low adherence in meeting nutrition recommendations among T1D children and adolescents, and particular concern emerged regarding high total fat and saturated fatty acid (SFA) intake [17][18][19][20][21][22][23][24][25][26]. Whether people with T1D were closer to guidelines than controls is debated, since contrasting results are described [13][18][21][23]. A lower adherence to recommendations was associated to poorer glycemic control, i.e., glycated hemoglobin A1c (HbA1c) levels, and therefore to the potential CVD risk and complications [11][22][23]. Of note, following a regular meal pattern was associated with better glycemic outcomes [18]. Moreover, a recent study showed how diet has changed in a 10-year period, showing that children and adolescents with T1D consume a higher amount of protein and fat and a lower amount of carbohydrate and fiber compared to 10 years ago [27]. Noteworthy, this study was conducted in Italy and therefore results may not be exported in other populations with different nutritional habits. Nevertheless, rapid changes and a deterioration of dietary habits, especially among youth, have been reported worldwide [28].
Nutritional variations seen in youth with T1D tend to follow the changes in the eating habits of the general population and, in particular, of their peers, who frequently do not meet the recommendations either [27][28]. Finally, it is worth mentioning that the food intake is frequently misreported, and especially under-reported, by children and adolescents with T1D and this should be considered when addressing the matter [29].

3. Fat intake and Glycemic Control in people with T1D

3.1. Food Intake and Postprandial Glycemic Control

Postprandial glycemic control is affected by food intake. It is mainly influenced by the amount of carbohydrate intake, along with insulin availability [30]. For this reason, guidelines recommend early nutrition education of individuals with T1D, including carbohydrate counting (CC), a meal planning approach based on the importance of carbohydrate in affecting postprandial glycaemia, used as a tool to improve glycemic control and facilitate flexible food choices [4][31][32]. Thus, insulin dosing at meals is generally decided upon the carbohydrate amount, often using insulin-to-carbohydrate ratio [31]. The importance of carbohydrate in affecting glycaemia has been known for long, however the impact of other diet macronutrients should also be considered. According to recommendations, to optimize postprandial glucose levels, other variables should be considered, including glycemic index, fat, protein and fiber intake [4]. It has been demonstrated that meals with high content of fat or protein lead to a delayed and prolonged increase in postprandial glycaemia, from 2 to 6 h after the meal, with small variations in ranges depending on the study considered [33][34][35][36]. An additive effect was reported when consuming high fat and high protein meals together [33]. Instead, early glycemic peak is reduced with high fat and high protein meals [37][38]. Based on these findings, new methods to establish a more accurate need of insulin that would consider the complexity of the meal were required. Indeed, some studies showed a better glycemic control when using algorithms for calculating insulin dose that account also for protein and fat intake, besides carbohydrate [39][40]. However, more frequent episodes of hypoglycemia were reported when using supplementary fat/protein counting than CC [39]. To note, the Food Insulin Index (FII) is a new algorithm in which foods are sorted by the insulin response to an isoenergetic reference food in healthy people. Since food energy is used as the constant, all foods and their metabolic interactions could be included in the algorithm, allowing a broader assessment of insulin demand [41]. Its use has been compared to CC in adult studies, showing a better control in postprandial glycaemia in subjects with T1D using FII [42][43], also specifically for protein-containing food [41]. However, no significant changes in HbA1c levels and relatively high rates of mild hypoglycemia with both methods were described [41][43]. The efficacy of novel counting methods in children and adolescents with T1D need further studies to be established, since no clear benefit among one method to another was reported up to now [44]. Considering the variation of glycaemia after high fat and/or high protein meals, insulin dose adjustments are recommended [4]. Additional dose of insulin in dual wave bolus and/or the increase in percentage of insulin dose were studied [36][45][46][47][48], even if determining what strategy is more efficient in glycemic control must be further assessed. Thus, it is recommended to adapt meal insulin dose to counterbalance the delayed hyperglycemia resulting from high protein and high fat meals. To the best of our knowledge, available hybrid closed-loop insulin pumps do not have algorithms for fat and/or protein dosing. Considering the wide inter-individual differences in insulin dose demand for fat and protein, it is therefore important to individualize the treatment [4].

3.2. Fat Intake and HbA1c

As indicated in the latest ADA recommendations [6], HbA1c target levels must be individualized, but on a general level it has been shown that a HbA1c target of 6.5% (48 mmol/mol) gives a higher number of patients that achieve a good metabolic control with a higher percentage of glucose values in time in range (3.9–10 mmol/L) and time in target (4.0–8.0 mmol/L) without more episodes of hypoglycaemia [49].
Considering the role of fat intake on HbA1c, mixed results have been reported. Some studies did not find any association between total fat intake and glycemic control [50][51], while, on the contrary, other studies showed that the consumption of fat is associated with HbA1c levels. In particular, a cross-sectional study in 252 young people affected by T1D reported that there was a higher risk of having a suboptimal HbA1c between insulin pump users consuming the highest quartile of fat intake [12]. Another cross-sectional study among 114 children and adolescents with T1D showed that HbA1c levels were positively correlated with lipid intake and SFA and negatively correlated with monounsaturated fatty acid (MUFA) intake. Interestingly, when increasing the SFA intake of 1% of total energy, the risk of having HbA1c >7.5% increases by 53% [13]. A more recent study confirmed the results on MUFA intake, showing that a higher MUFA intake lowered the risk of having a HbA1c higher than 7.5%, independently from confounders [27]. The prospective Diabetes Control and Complication Trial showed an association between higher HbA1c concentrations and higher SFA, MUFA, and total fat intakes. Moreover, higher HbA1c concentrations were seen when substituting fat for carbohydrate intake, even though this association weakened after adjusting for baseline HbA1c and concurrent insulin dose [14]. In a behavioral nutrition intervention study in 136 adolescents with T1D, as regard lipids, a better glycemic control, i.e., lower HbA1c, was associated with lower percentage of energy from unsaturated fat intake, while no significant associations were found for total fat and SFA [52]. Another study reporting data from 1000 adults with T1D showed that MUFA intake was associated with higher variability in blood glucose measurements. When analyzing the macronutrient substitution, favoring fat intake over protein or favoring SFA over either MUFA or polyunsaturated fatty acids (PUFA) were associated with higher mean self-monitored blood glucose concentrations. However, these effects were no longer significant after adjusting for fiber intake. After that adjustment, it resulted that favoring either carbohydrate or fat over protein or favoring carbohydrate for fat were associated with higher glycemic excursions [53]. Finally, in adults with T1D, fat intake negatively correlated with time spent in euglycemia and positively correlated with time spent in hyperglycemia. To note, it was not correlated with time spent in hypoglycemia [15]. In this regard, the type of fat intake has shown different impact on hypoglycemic risk. In fact, while there was no correlation between daytime non-severe hypoglycemia and total or SFA intake, unsaturated fat was found to be protective of daytime hypoglycemia. Of note, when adjusting for total daily insulin dose per kilogram these associations were lost [54].
An adequate comparison between the abovementioned studies is difficult to obtain since they sometimes express results in different ways. However, it seems reasonable to assess that there is a relationship between lipid intake and glucose control in individuals with T1D. In particular, higher HbA1c levels have been more frequently reported by individuals having a high fat and SFA intake, while contrasting data are reported for unsaturated fatty acids. Further prospective studies are needed to clarify this issue.

3.3. Low-Carbohydrate (High-Fat) Diets

When addressing glycemic control, restrictive diets and particularly low-carbohydrate diets are worth mentioning, especially if considering the current arousing interest for such approaches. The rationale behind these diets is that several studies showed a worse glycemic control with higher carbohydrate intake in people with T1D and vice versa, i.e., better glycemic control with lower carbohydrate intake or lower glycemic-index diets [51][53][55][56][57]. However, in the general population it was demonstrated that both high and low percentages of carbohydrate diets were associated with increased mortality, with the lowest risk reported at 50–55% energy from carbohydrate [58].
There is no univocal definition of low-carbohydrate diets, since the term refers to different nutrition regimens that can be gathered as follows. Low-carbohydrate diets generally contain less than 100 g of carbohydrate per day, with macronutrient distribution amounting to 50–60% of fat, less than 30% of carbohydrate and 20–30% of protein. Very-low carbohydrate diets, with generally less than 50 g of carbohydrate per day, are ketogenic diets in which energy production depends on burning fat and the production of ketone bodies [59]. To guarantee energy requirements, a reduction of carbohydrate intake should be compensated by an increase of protein and lipid intakes. In detail, the individual needs to satisfy the energy requirement to maintain energy balance. The proportion of the different macronutrients may change but the total energy intake should guarantee total energy requirements. Therefore, if the amount of carbohydrate is reduced, an increase of fat and/or protein is necessary for compensating the energy reduction due to the lower carbohydrate intake. This may lead to a high-fat intake.
Recent reviews summarized the pros and cons of low-carbohydrate diets in people with T1D. Possible benefits of these diets are the improvement of glycemic control, the reduction of Hb1Ac levels and insulin requirement that may help to improve psychological outcomes, e.g., reducing diabetes distress and depressive symptoms [59][60][61][62]. In addition, low-carbohydrate diets may be a strategy for weight loss, if total energy intake is lower than the requirement [61]. Worth mentioning is a large online survey in youth and adults with self-reported T1D who followed a very-low carbohydrate diet (mean self-reported daily carbohydrate intake of 36 ± 15 g). The study reported HbA1c levels of 5.71% ± 0.58% in the pediatric age group, well below the ADA recommended target, and low rates of adverse diabetes-related medical events [63]. However, it is important to interpret those results with caution, mostly because of the self-selected sample and the self-reported data of carbohydrate intake and HbA1c levels [60][64]. Nevertheless, caution is needed with low-carbohydrate diets, and especially with very-low carbohydrate diets, because of the possible negative effects, such as the potential risk of diabetic ketoacidosis and oxidative stress, hypoglycemia and the reduced glucagon effect during hypoglycemia, the increase in saturated fatty acid consumption to maintain caloric intake and dyslipidemia, nutrient deficiencies and difficulties in maintaining these diets for long [59][60][61][62]. In growing children, low-carbohydrate diets may also negatively impact growth [59][61]. The unphysiological delivery of external insulin into the subcutaneous tissue instead of directly into the liver as in the non-diabetes situation leads in low-carbohydrate diets to more or less lack of insulin in the liver with e.g., less IGF-1 stimulation. Moreover, low-carbohydrate diets, as restrictive diets, may have adverse psychological outcomes, such as greater diabetes distress and augmented risk of eating disorders [60].
In summary, although low-carbohydrate diets and very-low carbohydrate diets may be effective in improving glycemic control, because of the potential important negative consequences of these diets, especially in children, we do not recommend the use of these diets for treating T1D, and caution is important when addressing to the topic [4][6][64].

References

  1. Atkinson, M.A.; Eisenbarth, G.S.; Michels, A.W. Type 1 Diabetes. Lancet 2014, 383, 69–82.
  2. Simmons, K.M. Type 1 Diabetes: A Predictable Disease. World J. Diabetes 2015, 6, 380–390.
  3. DiMeglio, L.A.; Acerini, C.L.; Codner, E.; Craig, M.E.; Hofer, S.E.; Pillay, K.; Maahs, D.M. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic Control Targets and Glucose Monitoring for Children, Adolescents, and Young Adults with Diabetes. Pediatric Diabetes 2018, 19, 105–114.
  4. Smart, C.E.; Annan, F.; Higgins, L.A.; Jelleryd, E.; Lopez, M.; Acerini, C.L. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional Management in Children and Adolescents with Diabetes. Pediatric Diabetes 2018, 19, 136–154.
  5. Adolfsson, P.; Riddell, M.C.; Taplin, C.E.; Davis, E.A.; Fournier, P.A.; Annan, F.; Scaramuzza, A.E.; Hasnani, D.; Hofer, S.E. ISPAD Clinical Practice Consensus Guidelines 2018: Exercise in Children and Adolescents with Diabetes. Pediatric Diabetes 2018, 19, 205–226.
  6. American Diabetes Association. 13. Children and Adolescents: Standards of Medical Care in Diabetes—2021. Diabetes Care 2021, 44 (Suppl. 1), S180–S199.
  7. Shi, M.; Tang, R.; Huang, F.; Zhong, T.; Chen, Y.; Li, X.; Zhou, Z. Cardiovascular Disease in Patients with Type 1 Diabetes: Early Evaluation, Risk Factors and Possible Relation with Cardiac Autoimmunity. Diabetes Metab. Res. Rev. 2020, e3423.
  8. Benjamin, E.J.; Blaha, M.J.; Chiuve, S.E.; Cushman, M.; Das, S.R.; Deo, R.; De Ferranti, S.D.; Floyd, J.; Fornage, M.; Gillespie, C.; et al. Heart Disease and Stroke Statistics’2017 Update: A Report from the American Heart Association. Circulation 2017, 135, e146–e603.
  9. Pihoker, C.; Forsander, G.; Fantahun, B.; Virmani, A.; Corathers, S.; Benitez-Aguirre, P.; Fu, J.; Maahs, D.M. ISPAD Clinical Practice Consensus Guidelines 2018: The Delivery of Ambulatory Diabetes Care to Children and Adolescents with Diabetes. Pediatric Diabetes 2018, 19, 84–104.
  10. Bebu, I.; Braffett, B.H.; Orchard, T.J.; Lorenzi, G.M.; Lachin, J.M. Mediation of the Effect of Glycemia on the Risk of CVD Outcomes in Type 1 Diabetes: The DCCT/EDIC Study. Diabetes Care 2019, 42, 1284–1289.
  11. Ahola, A.J.; Freese, R.; Mäkimattila, S.; Forsblom, C.; Groop, P.-H. Dietary Patterns Are Associated with Various Vascular Health Markers and Complications in Type 1 Diabetes. J. Diabetes Complicat. 2016, 30, 1144–1150.
  12. Katz, M.L.; Mehta, S.; Nansel, T.; Quinn, H.; Lipsky, L.M.; Laffel, L.M.B. Associations of Nutrient Intake with Glycemic Control in Youth with Type 1 Diabetes: Differences by Insulin Regimen. Diabetes Technol. Ther. 2014, 16, 512–518.
  13. Maffeis, C.; Morandi, A.; Ventura, E.; Sabbion, A.; Contreas, G.; Tomasselli, F.; Tommasi, M.; Fasan, I.; Costantini, S.; Pinelli, L. Diet, Physical, and Biochemical Characteristics of Children and Adolescents with Type 1 Diabetes: Relationship between Dietary Fat and Glucose Control. Pediatric Diabetes 2012, 13, 137–146.
  14. Delahanty, L.M.; Nathan, D.M.; Lachin, J.M.; Hu, F.B.; Cleary, P.A.; Ziegler, G.K.; Wylie-Rosett, J.; Wexler, D.J. Association of Diet with Glycated Hemoglobin during Intensive Treatment of Type 1 Diabetes in the Diabetes Control and Complications Trial. Am. J. Clin. Nutr. 2009, 89, 518–524.
  15. Ayano-Takahara, S.; Ikeda, K.; Fujimoto, S.; Asai, K.; Oguri, Y.; Harashima, S.I.; Tsuji, H.; Shide, K.; Inagaki, N. Carbohydrate Intake Is Associated with Time Spent in the Euglycemic Range in Patients with Type 1 Diabetes. J. Diabetes Investig. 2015, 6, 678–686.
  16. Maffeis, C.; Fornari, E.; Morandi, A.; Piona, C.; Tomasselli, F.; Tommasi, M.; Marigliano, M. Glucose-Independent Association of Adiposity and Diet Composition with Cardiovascular Risk in Children and Adolescents with Type 1 Diabetes. Acta Diabetol. 2017, 54, 599–605.
  17. Mackey, E.R.; Rose, M.; Tully, C.; Monaghan, M.; Hamburger, S.; Herrera, N.; Streisand, R. The Current State of Parent Feeding Behavior, Child Eating Behavior, and Nutrition Intake in Young Children with Type 1 Diabetes. Pediatric Diabetes 2020, 21, 841–845.
  18. Seckold, R.; Howley, P.; King, B.R.; Bell, K.; Smith, A.; Smart, C.E. Dietary Intake and Eating Patterns of Young Children with Type 1 Diabetes Achieving Glycemic Targets. BMJ Open Diabetes Res. Care 2019, 7, e000663.
  19. Stechova, K.; Hlubik, J.; Pithova, P.; Cikl, P.; Lhotska, L. Comprehensive Analysis of the Real Lifestyles of T1D Patients for the Purpose of Designing a Personalized Counselor for Prandial Insulin Dosing. Nutrients 2019, 11, 1148.
  20. Thomson, R.; Adams, L.; Anderson, J.; Maftei, O.; Couper, J.; Giles, L.; Peña, A.S. Australian Children with Type 1 Diabetes Consume High Sodium and High Saturated Fat Diets: Comparison with National and International Guidelines. J. Paediatr. Child Health 2019, 55, 1188–1193.
  21. Ewers, B.; Trolle, E.; Jacobsen, S.S.; Vististen, D.; Almdal, T.P.; Vilsbøll, T.; Bruun, J.M. Dietary Habits and Adherence to Dietary Recommendations in Patients with Type 1 and Type 2 Diabetes Compared with the General Population in Denmark. Nutrition 2019, 61, 49–55.
  22. Mackey, E.R.; O’Brecht, L.; Holmes, C.S.; Jacobs, M.; Streisand, R. Teens with Type 1 Diabetes: How Does Their Nutrition Measure Up? J. Diabetes Res. 2018, 2018, 5094569.
  23. Øverby, N.C.; Flaaten, V.; Veierød, M.B.; Bergstad, I.; Margeirsdottir, H.D.; Dahl-Jørgensen, K.; Andersen, L.F. Children and Adolescents with Type 1 Diabetes Eat a More Atherosclerosis-Prone Diet than Healthy Control Subjects. Diabetologia 2007, 50, 307–316.
  24. Mayer-Davis, E.J.; Nichols, M.; Liese, A.D.; Bell, R.A.; Dabelea, D.M.; Johansen, J.M.; Pihoker, C.; Rodriguez, B.L.; Thomas, J.; Williams, D. Dietary Intake among Youth with Diabetes: The SEARCH for Diabetes in Youth Study. J. Am. Diet. Assoc. 2006, 106, 689–697.
  25. Nansel, T.R.; Haynie, D.L.; Lipsky, L.M.; Laffel, L.M.B.; Mehta, S.N. Multiple Indicators of Poor Diet Quality in Children and Adolescents with Type 1 Diabetes Are Associated with Higher Body Mass Index Percentile but Not Glycemic Control. J. Acad. Nutr. Diet. 2012, 112, 1728–1735.
  26. Helgeson, V.S.; Viccaro, L.; Becker, D.; Escobar, O.; Siminerio, L. Diet of Adolescents With and Without Diabetes: Trading Candy for Potato Chips? Diabetes Care 2006, 29, 982–987.
  27. Maffeis, C.; Tomasselli, F.; Tommasi, M.; Bresadola, I.; Trandev, T.; Fornari, E.; Marigliano, M.; Morandi, A.; Olivieri, F.; Piona, C. Nutrition Habits of Children and Adolescents with Type 1 Diabetes Changed in a 10 Years Span. Pediatric Diabetes 2020, 21, 960–968.
  28. Rosi, A.; Paolella, G.; Biasini, B.; Scazzina, F. Dietary Habits of Adolescents Living in North America, Europe or Oceania: A Review on Fruit, Vegetable and Legume Consumption, Sodium Intake, and Adherence to the Mediterranean Diet. Nutr. Metab. Cardiovasc. Dis. 2019, 29, 544–560.
  29. Maffeis, C.; Schutz, Y.; Fornari, E.; Marigliano, M.; Tomasselli, F.; Tommasi, M.; Chini, V.; Morandi, A. Bias in Food Intake Reporting in Children and Adolescents with Type 1 Diabetes: The Role of Body Size, Age and Gender. Pediatric Diabetes 2017, 18, 213–221.
  30. Rabasa-Lhoret, R.; Garon, J.; Langelier, H.; Poisson, D.; Chiasson, J.L. Effects of Meal Carbohydrate Content on Insulin Requirements in Type 1 Diabetic Patients Treated Intensively with the Basal-Bolus (Ultralente- Regular) Insulin Regimen. Diabetes Care 1999, 22, 667–673.
  31. Kawamura, T. The Importance of Carbohydrate Counting in the Treatment of Children with Diabetes. Pediatric Diabetes 2007, 8 (Suppl. 6), 57–62.
  32. Tascini, G.; Berioli, M.G.; Cerquiglini, L.; Santi, E.; Mancini, G.; Rogari, F.; Toni, G.; Esposito, S. Carbohydrate Counting in Children and Adolescents with Type 1 Diabetes. Nutrients 2018, 10, 109.
  33. Smart, C.E.M.; Evans, M.; O’Connell, S.M.; McElduff, P.; Lopez, P.E.; Jones, T.W.; Davis, E.A.; King, B.R. Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children with Type 1 Diabetes, and the Effect Is Additive. Diabetes Care 2013, 36, 3897–3902.
  34. Paterson, M.A.; Smart, C.E.M.; Lopez, P.E.; Mcelduff, P.; Attia, J.; Morbey, C.; King, B.R. Influence of Dietary Protein on Postprandial Blood Glucose Levels in Individuals with Type 1 Diabetes Mellitus Using Intensive Insulin Therapy. Diabet. Med. 2016, 33, 592–598.
  35. Abdou, M.; Hafez, M.H.; Anwar, G.M.; Fahmy, W.A.; Al Fattah, M.A.; Salem, R.I.; Arafa, N. Effect of High Protein and Fat Diet on Postprandial Blood Glucose Levels in Children and Adolescents with Type 1 Diabetes in Cairo, Egypt. Diabetes Metab. Syndr. Clin. Res. Rev. 2021, 15, 7–12.
  36. Pańkowska, E.; Błazik, M.; Groele, L. Does the Fat-Protein Meal Increase Postprandial Glucose Level in Type 1 Diabetes Patients on Insulin Pump: The Conclusion of a Randomized Study. Diabetes Technol. Ther. 2012, 14, 16–22.
  37. Paterson, M.A.; Smart, C.E.M.; Lopez, P.E.; Howley, P.; McElduff, P.; Attia, J.; Morbey, C.; King, B.R. Increasing the Protein Quantity in a Meal Results in Dose-Dependent Effects on Postprandial Glucose Levels in Individuals with Type 1 Diabetes Mellitus. Diabet. Med. 2017, 34, 851–854.
  38. Lodefalk, M.; Åman, J.; Bang, P. Effects of Fat Supplementation on Glycaemic Response and Gastric Emptying in Adolescents with Type 1 Diabetes. Diabet. Med. 2008, 25, 1030–1035.
  39. Kordonouri, O.; Hartmann, R.; Remus, K.; Bläsig, S.; Sadeghian, E.; Danne, T. Benefit of Supplementary Fat plus Protein Counting as Compared with Conventional Carbohydrate Counting for Insulin Bolus Calculation in Children with Pump Therapy. Pediatric Diabetes 2012, 13, 540–544.
  40. Kaya, N.; Kurtoğlu, S.; Gökmen Özel, H. Does Meal-Time Insulin Dosing Based on Fat-Protein Counting Give Positive Results in Postprandial Glycaemic Profile after a High Protein-Fat Meal in Adolescents with Type 1 Diabetes: A Randomised Controlled Trial. J. Hum. Nutr. Diet. 2020, 33, 396–403.
  41. Bell, K.J.; Gray, R.; Munns, D.; Petocz, P.; Howard, G.; Colagiuri, S.; Brand-Miller, J.C. Estimating Insulin Demand for Protein-Containing Foods Using the Food Insulin Index. Eur. J. Clin. Nutr. 2014, 68, 1055–1059.
  42. Bao, J.; Gilbertson, H.R.; Gray, A.R.; Munns, D.; Howard, G.; Petocz, P.; Colagiuri, S.; Brand-Miller, J.C. Improving the Estimation of Mealtime Insulin Dose in Adults with Type 1 Diabetes: The Normal Insulin Demand for Dose Adjustment (NIDDA) Study. Diabetes Care 2011, 34, 2146–2151.
  43. Bell, K.J.; Gray, R.; Munns, D.; Petocz, P.; Steil, G.; Howard, G.; Colagiuri, S.; Brand-Miller, J.C. Clinical Application of the Food Insulin Index for Mealtime Insulin Dosing in Adults with Type 1 Diabetes: A Randomized Controlled Trial. Diabetes Technol. Ther. 2016, 18, 218–225.
  44. Lopez, P.E.; Evans, M.; King, B.R.; Jones, T.W.; Bell, K.; McElduff, P.; Davis, E.A.; Smart, C.E. A Randomized Comparison of Three Prandial Insulin Dosing Algorithms for Children and Adolescents with Type 1 Diabetes. Diabet. Med. 2018, 35, 1440–1447.
  45. Bell, K.J.; Smart, C.E.; Steil, G.M.; Brand-Miller, J.C.; King, B.; Wolpert, H.A. Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era. Diabetes Care 2015, 38, 1008–1015.
  46. Bell, K.J.; Toschi, E.; Steil, G.M.; Wolpert, H.A. Optimized Mealtime Insulin Dosing for Fat and Protein in Type 1 Diabetes: Application of a Model-Based Approach to Derive Insulin Doses for Open-Loop Diabetes Management. Diabetes Care 2016, 39, 1631–1634.
  47. Piechowiak, K.; Dżygało, K.; Szypowska, A. The Additional Dose of Insulin for High-Protein Mixed Meal Provides Better Glycemic Control in Children with Type 1 Diabetes on Insulin Pumps: Randomized Cross-over Study. Pediatric Diabetes 2017, 18, 861–868.
  48. Lopez, P.E.; Smart, C.E.; McElduff, P.; Foskett, D.C.; Price, D.A.; Paterson, M.A.; King, B.R. Optimizing the Combination Insulin Bolus Split for a High-Fat, High-Protein Meal in Children and Adolescents Using Insulin Pump Therapy. Diabet. Med. 2017, 34, 1380–1384.
  49. Swedish National Diabetes Registry. Available online: https://www.ndr.nu/#/knappen (accessed on 11 July 2021).
  50. Balk, S.N.; Schoenaker, D.A.J.M.; Mishra, G.D.; Toeller, M.; Chaturvedi, N.; Fuller, J.H.; Soedamah-Muthu, S.S. Association of Diet and Lifestyle with Glycated Haemoglobin in Type 1 Diabetes Participants in the EURODIAB Prospective Complications Study. Eur. J. Clin. Nutr. 2016, 70, 229–236.
  51. Lamichhane, A.P.; Crandell, J.L.; Jaacks, L.M.; Couch, S.C.; Lawrence, J.M.; Mayer-Davis, E.J. Longitudinal Associations of Nutritional Factors with Glycated Hemoglobin in Youth with Type 1 Diabetes: The SEARCH Nutrition Ancillary Study. Am. J. Clin. Nutr. 2015, 101, 1278–1285.
  52. Nansel, T.R.; Lipsky, L.M.; Liu, A. Greater Diet Quality Is Associated with More Optimal Glycemic Control in a Longitudinal Study of Youth with Type 1 Diabetes. Am. J. Clin. Nutr. 2016, 104, 81–87.
  53. Ahola, A.J.; Harjutsalo, V.; Forsblom, C.; Saraheimo, M.; Groop, P.H. Associations of Dietary Macronutrient and Fibre Intake with Glycaemia in Individuals with Type 1 Diabetes. Diabet. Med. 2019, 36, 1391–1398.
  54. Zhong, V.W.; Crandell, J.L.; Shay, C.M.; Gordon-Larsen, P.; Cole, S.R.; Juhaeri, J.; Kahkoska, A.R.; Maahs, D.M.; Seid, M.; Forlenza, G.P.; et al. Dietary Intake and Risk of Non-Severe Hypoglycemia in Adolescents with Type 1 Diabetes. J. Diabetes Complicat. 2017, 31, 1340–1347.
  55. Ahola, A.J.; Forsblom, C.; Harjutsalo, V.; Groop, P.H. Dietary Carbohydrate Intake and Cardio-Metabolic Risk Factors in Type 1 Diabetes. Diabetes Res. Clin. Pract. 2019, 155, 107818.
  56. Meissner, T.; Wolf, J.; Kersting, M.; Fröhlich-Reiterer, E.; Flechtner-Mors, M.; Salgin, B.; Stahl-Pehe, A.; Holl, R.W. Carbohydrate Intake in Relation to BMI, HbA1c and Lipid Profile in Children Andadolescents with Type 1 Diabetes. Clin. Nutr. 2014, 33, 75–78.
  57. Zafar, M.I.; Mills, K.E.; Zheng, J.; Regmi, A.; Hu, S.Q.; Gou, L.; Chen, L.L. Low-Glycemic Index Diets as an Intervention for Diabetes: A Systematic Review and Meta-Analysis. Am. J. Clin. Nutr. 2019, 110, 891–902.
  58. Seidelmann, S.B.; Claggett, B.; Cheng, S.; Henglin, M.; Shah, A.; Steffen, L.M.; Folsom, A.R.; Rimm, E.B.; Willett, W.C.; Solomon, S.D. Dietary Carbohydrate Intake and Mortality: A Prospective Cohort Study and Meta-Analysis. Lancet. Public Health 2018, 3, e419–e428.
  59. Bolla, A.M.; Caretto, A.; Laurenzi, A.; Scavini, M.; Piemonti, L. Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes. Nutrients 2019, 11, 962.
  60. Gallagher, K.A.S.; DeSalvo, D.; Gregory, J.; Hilliard, M.E. Medical and Psychological Considerations for Carbohydrate-Restricted Diets in Youth With Type 1 Diabetes. Curr. Diab. Rep. 2019, 19, 27.
  61. Scott, S.N.; Anderson, L.; Morton, J.P.; Wagenmakers, A.J.M.; Riddell, M.C. Carbohydrate Restriction in Type 1 Diabetes: A Realistic Therapy for Improved Glycaemic Control and Athletic Performance? Nutrients 2019, 11, 1022.
  62. Seckold, R.; Fisher, E.; de Bock, M.; King, B.R.; Smart, C.E. The Ups and Downs of Low-Carbohydrate Diets in the Management of Type 1 Diabetes: A Review of Clinical Outcomes. Diabet. Med. 2019, 36, 326–334.
  63. Lennerz, B.S.; Barton, A.; Bernstein, R.K.; Dikeman, R.D.; Diulus, C.; Hallberg, S.; Rhodes, E.T.; Ebbeling, C.B.; Westman, E.C.; Yancy Jr, W.S.; et al. Management of Type 1 Diabetes With a Very Low-Carbohydrate Diet. Pediatrics 2018, 141, e20173349.
  64. Mayer-Davis, E.J.; Laffel, L.M.; Buse, J.B. Management of Type 1 Diabetes with a Very Low–Carbohydrate Diet: A Word of Caution. Pediatrics 2018, 142, e20181536B.
More
© Text is available under the terms and conditions of the Creative Commons Attribution (CC BY) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.
Upload a video for this entry
Information
Subjects: Nutrition & Dietetics
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
Chiara Garonzi
,
Gun Forsander
,
Claudio Maffeis
View Times: 426
Revision: 1 time (View History)
Update Date: 11 Nov 2021
Table of Contents
    1000/1000
    Hot Most Recent
    Feedback