Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive

Smart, Carmel E.M.; Evans, Megan; O’Connell, Susan M.; McElduff, Patrick; Lopez, Prudence E.; Jones, Timothy W.; Davis, Elizabeth A.; King, Bruce R.

doi:10.2337/dc13-1195

Cited by 240Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive

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Smart, Carmel E.M., Evans, Megan, O’Connell, Susan M., McElduff, Patrick, Lopez, Prudence E., Jones, Timothy W., Davis, Elizabeth A., King, Bruce R.·2013·Diabetes Care

DOI 10.2337/dc13-1195PMC PMC3836096

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Abstract

OBJECTIVE: To determine the separate and combined effects of high-protein (HP) and high-fat (HF) meals, with the same carbohydrate content, on postprandial glycemia in children using intensive insulin therapy (IIT). RESEARCH DESIGN AND METHODS: Thirty-three subjects aged 8-17 years were given 4 test breakfasts with the same carbohydrate amount but varying protein and fat quantities: low fat (LF)/low protein (LP), LF/HP, HF/LP, and HF/HP. LF and HF meals contained 4 g and 35 g fat. LP and HP meals contained 5 g and 40 g protein. An individually standardized insulin dose was given for each meal. Postprandial glycemia was assessed by 5-h continuous glucose monitoring. RESULTS: Compared with the LF/LP meal, mean glucose excursions were greater from 180 min after the LF/HP meal (2.4 mmol/L [95% CI 1.1-3.7] vs. 0.5 mmol/L [-0.8 to 1.8]; P = 0.02) and from 210 min after the HF/LP meal (1.8 mmol/L [0.3-3.2] vs. -0.5 mmol/L [-1.9 to 0.8]; P = 0.01). The HF/HP meal resulted in higher glucose excursions from 180 min to 300 min (P < 0.04) compared with all other meals. There was a reduction in the risk of hypoglycemia after the HP meals (odds ratio 0.16 [95% CI 0.06-0.41]; P < 0.001). CONCLUSIONS: Meals high in protein or fat increase glucose excursions in youth using IIT from 3 h to 5 h postmeal. Protein and fat have an additive impact on the delayed postprandial glycemic rise. Protein had a protective effect on the development of hypoglycemia.

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Dietary fat and protein can impact early and delayed postprandial glycemia, and it appears to have a dose-dependent response.
“Studies have shown that dietary fat and protein can impact early and delayed postprandial glycemia (184-187), and it appears to have a dose-dependent response (188)(189)(190)(191).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023 (2023) · cites this paper as [186]

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Authors: Smart, C. E. M., Evans, M., O’Connell, S. M., McElduff, P., Lopez, P. E., Jones, T. W., Davis, E. A., & King, B. R.
Affiliations: Hunter Medical Research Institute (AU)
Princess Margaret Hospital for Children (AU)
Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
The Kids Research Institute Australia (AU)
John Hunter Children's Hospital (AU)
Corresponding author: King, Bruce R.
ORCID: Smart, Carmel E.M.
McElduff, Patrick
Lopez, Prudence E.
Jones, Timothy W.
Davis, Elizabeth A.
King, Bruce R.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2013-11-13
Volume: 36
Issue: 12
Pages: 3897-3902
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc13-1195
PMC: PMC3836096
OpenAlex: W2161131222
Cited by: 240
References: 19
Citations by year: 2026: 15 · 2025: 16 · 2024: 26 · 2023: 24 · 2022: 15 · 2021: 26 · 2020: 21 · 2019: 19 · 2018: 19 · 2017: 18 · 2016: 17 · 2015: 12 · 2014: 10 · 2013: 1 · 2012: 1
FWCI: 10.49
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
Locations: Diabetes Care (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
NOVA (University of Newcastle Australia) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: type 1 diabetes, children, postprandial blood glucose, dietary protein, dietary fat, protein-rich meals, high-fat meal, intensive insulin therapy, hypoglycemia, additive effects, breakfast, continuous glucose monitoring
MeSH terms: Adolescent, Blood Glucose, Child, Diabetes Mellitus, Type 1, Dietary Fats, Dietary Proteins, Female, Follow-Up Studies, Humans, Insulin, Male, Cross-Over Studies, Postprandial Period, Infusions, Subcutaneous

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Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive

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