Impact of Fat Intake on Blood Glucose Control and Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes

Abstract

Nutrition therapy is a cornerstone of type 1 diabetes (T1D) management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. However, the specific role of macronutrients is still debated, particularly fat intake. This review aims at assessing the relationship between fat intake and glycemic control, cardiovascular risk factors, inflammation, and microbiota, in children and adolescents with T1D. High fat meals are followed by delayed and prolonged hyperglycemia and higher glycated hemoglobin A1c levels have been frequently reported in individuals with T1D consuming high amounts of fat. High fat intake has also been associated with increased cardiovascular risk, which is higher in people with diabetes than in healthy subjects. Finally, high fat meals lead to postprandial pro-inflammatory responses through different mechanisms, including gut microbiota modifications. Different fatty acids were proposed to have a specific role in metabolic regulation, however, further investigation is still necessary. In conclusion, available evidence suggests that a high fat intake should be avoided by children and adolescents with T1D, who should be encouraged to adhere to a healthy and balanced diet, as suggested by ISPAD and ADA recommendations. This nutritional choice might be beneficial for reducing cardiovascular risk and inflammation.

Interactions between genetic and lifestyle factors on cardiometabolic disease-related outcomes in Latin American and Caribbean populations: A systematic review

“…Similarly, the second BOLD study ( 73 ) which also examined the interaction between dietary fat intake and a 10-SNP metabolic-GRS did not find significant interactions between the GRS and dietary fat intake on fasting glucose, fasting insulin or HbA1c ( Table 1 ). The mechanisms through which dietary fat intake influence glycemic traits are unclear, although a sustained increase in blood glucose levels following a high fat meal has been reported ( 74 ).…”

E-DES-PROT: A novel computational model to describe the effects of amino acids and protein on postprandial glucose and insulin dynamics in humans

“…Furthermore, not only AAs but also fat influences the blood glucose response in response to complex meals. 26 , 27 However, incorporating the postprandial effects of fat on glucose metabolism was beyond the scope of this present study. Identifiability analysis showed that the parameters related to AAs ( k 11– k 13) were identifiable for AA challenges and milk protein ingredients (examples are shown in Figure S3 ).…”

Interactions between Vitamin D Genetic Risk and Dietary Factors on Metabolic Disease-Related Outcomes in Ghanaian Adults

“…Additionally, a cross-sectional study in 150 adult participants from New Zealand found that increased SFA was associated with a 6% (95% CI 2-10%; p = 0.004) increase in HbA1c and concluded that reducing SFA maybe helpful in improving glycemic control [83]. Total fat intake seems to have an effect on HbA1c levels; this could be caused by reduced insulin sensitivity, or it could be because higher fat intake is causing an increased hepatic glucose production, which can cause an increase in the peak time and amount of the glucose response [84,85]. Evidence that dietary fat intake can affect glycemic control in vitamin-D-susceptible individuals has important implications for developing strategies to prevent T2D in this subgroup.…”