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Insulin Requirements Increased by High-Fat Meals

An increase in dietary fat can raise glucose levels and insulin requirements in patients with type 1 diabetes….

A recent study, observed the effects of high fat meals on glucose levels and insulin requirements in type 1 diabetics. The study incorporated seven patients with type 1 diabetes and an average age of 55 years old. The patients were fed all breakfasts and lunches that were low fat, but were given either a low-fat or high-fat dinner. The dinners had the same carbohydrate and protein content. The patients’ insulin was automatically regulated by a closed- loop system for two 18-hour periods before dinner. In addition, their glucose and insulin levels were tested at certain intervals.

The results showed that the patients that ate high-fat meals at dinner required more insulin than the low-fat dinner participants (12.6 units compared to 9 units). The high-fat dinner patients had higher glucose levels even with insulin levels increased five to ten hours after dinner. The insulin requirements with a high-fat dinner increased on average by 42 percent.

Dr. Howard Wolpert, MD, Senior Physician in the Joslin Clinic Section on Adult Diabetes and the Director of the Insulin Pump Program says, "These findings highlight the limitations of basing mealtime insulin dosing for type 1 diabetes solely on carbohydrate intake. We need to consider fat as well as carbohydrates in insulin dosing calculations as well as in nutritional recommendations."

This study provides evidence that high fat meals can influence the amount of insulin needed in a type 1 diabetic patient. This can be very useful information that can be used to optimize glucose control and individualize insulin therapy once it is duplicated with a larger study.

Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes: Implications for carbohydrate-based bolus dose calculation and intensive diabetes management. Diabetes Care, 2012; 36 (4): 810 DOI: 10.2337/dc12-0092