Pediatr Diabetes. 2021 Oct 31. doi: 10.1111/pedi.13273. Online ahead of print.
ABSTRACT
AIMS: To determine the glycaemic impact of dietary fat alone consumed without prandial insulin in individuals with T1D.
METHODS: Thirty participants with T1D (aged 8-18 years) consumed a test drink with either 20g glucose or 1, 13, 26, 39, 51g of fat with negligible carbohydrate/protein on 6 consecutive evenings, in a randomised order without insulin. Continuous glucose monitoring was used to measure glucose levels for 8 hours postprandially. Primary outcome was mean glycaemic excursion at each 30minute interval for each test condition. Generalised linear mixed models with a random effect for people with diabetes were used to test for an increase in blood glucose excursion with increasing quantity of fat.
RESULTS: Glycaemic excursions after 20g glucose were higher than after fat drinks over the first two hours (P < 0.05). Glycaemic excursion for the fat drinks demonstrated a dose response, statistically significant from four hours (P = 0.026), such that increasing loads of fat caused a proportionally larger increase in glycaemic excursion, remaining statistically significant until eight hours (P < 0.05). Overall, for every 10g fat added to the drink, glucose concentrations rose by a mean of 0.28mMol L-1 from 330 mins (95% CI 0.15 to 0.39, P < 0.001).
CONCLUSIONS: Fat ingested without other macronutrients increases glucose excursions from four to eight hours after ingestion, in a dose dependent manner. These observations may impact on insulin dosing for high-fat foods in individuals with T1D. This article is protected by copyright. All rights reserved.
PMID:34719089 | DOI:10.1111/pedi.13273
