Does Protein and Fat Content of Meal Increase Glucose Concentrations

Does High-Protein High-Fat Meal Increase Postprandial Glucose Concentrations and Meal-Time Insulin Requirements in Patients With Type 1 Diabetes on Basal-Bolus Insulin Regimen: A Randomized Controlled Trial

The study investigated the effects of fat protein counting (CFP) in addition to carbohydrate (CARB) counting for calculating prandial insulin dosage on blood glucose profile in patients with type 1 diabetes (T1D) on basal-bolus insulin therapy.

In this single center, crossover, randomized, controlled study, control meal (SM: standard meal using carbohydrate counting method) and three test meals (HPM: high protein meal using carbohydrate counting method, HPFM-a: high protein-fat meal using carbohydrate counting method and HPFM-b: high protein-fat meal using carbohydrate and fat-protein counting method) were compared on postprandial early (0-120 minutes), late (120-240 minutes) and total (0-240 minutes) glucose response.

Inclusion Criteria:

Subjects:

• had Type1 Diabetes for at least 1 years;
• use multiple dose (basal-bolus) insulin therapy;
• use fast-acting insulin analogs (lispro, glulisine, and aspart) and basal insulin analogs (detemir, glargine);
• daily inslin dose ≥0.5 IU/kg/day.

Exclusion Criteria:

Subjects:

• had any restrictive food intake disorders (eg celiac disease or food allergy);
• had any diabetes complications (eg neuropathy, nephropathy or retinopathy);
• diagnosed for <1 year;
• were using corticosteroid or any medication that could effect gastric emptying;
• did exercise or had hypoglycemia or ketoacidosis within 24 hour before the test meals;
• had overweight or obese (BMI z score: ≥ 1SD and ≥ 2SD respectively);
• had not on follicular or peri-ovulatory phases of their menstrual cycles (for females).