A low-fat diet improves peripheral insulin sensitivity in patients with Type 1 diabetes

Diabet Med. 2006 Apr;23(4):384-92. doi: 10.1111/j.1464-5491.2005.01810.x.

Abstract

Aims: To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes.

Methods: Thirteen Type 1 patients were included, of whom 10 completed the cross-over study. Ten non-diabetic, matched control subjects were also examined. Body composition was estimated by dual-energy X-ray absorptiometry (DXA) whole-body scanning, diet intake was monitored by 7-day dietary record and insulin sensitivity was measured by the insulin clamp technique at baseline and after each of the diet intervention periods.

Results: On an isocaloric low-fat diet, Type 1 diabetic patients significantly reduced the proportion of fat in the total daily energy intake by 12.1% (or -3.6% of total energy) as compared with a conventional diabetes diet (P = 0.039). The daily protein and carbohydrate intake increased (+4.4% of total energy intake, P = 0.0049 and +2.5%, P = 0.34, respectively), while alcohol intake decreased (-3.2% of total energy intake, P = 0.02). There was a significant improvement in insulin sensitivity on the isocaloric, low-fat diet compared with the standard diabetes diet [7.06 +/- 2.16 mg/kg/min (mean +/- sd) vs. 5.52 +/- 2.35 mg/kg/min (P = 0.03)]. However, insulin sensitivity remained 33% lower than in the control subjects (P = 0.021). No significant changes occurred in body weight or body composition. Glycated haemoglobin rose during both diet intervention periods (P = 0.18), with no difference between the two diets.

Conclusions: Change to an isocaloric, low-fat diet in Type 1 diabetic patients during a 3-month period resulted in significant improvement in insulin sensitivity without improvement in glycaemic control. However, insulin sensitivity remained 33% lower than in control subjects.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Blood Glucose / analysis
  • Body Composition
  • Case-Control Studies
  • Cross-Over Studies
  • Diabetes Mellitus, Type 1 / diet therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diet, Diabetic
  • Diet, Fat-Restricted*
  • Dietary Carbohydrates / administration & dosage
  • Energy Intake
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Statistics, Nonparametric

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Glycated Hemoglobin A