Extra insulin dose may protect type 1 diabetics from heart disease

By Paul Basilio, MDLinx
Published June 7, 2017

Key Takeaways

Results of a small preliminary trial in the UK show that an additional dose of insulin after a high-fat meal can help regulate blood sugar levels and protect against long-term risk for cardiovascular disease in patients with type 1 diabetes. The study was published in Diabetes and Vascular Disease Research.

The extra dose can also reduce fat and inflammatory markers in the blood that can damage blood vessels and heart disease.

In the UK, most patients with type 1 diabetes inject insulin throughout the day. The dose following meals is usually calculated using the amount of carbohydrates in the food. However, this calculation does not include the fat content, which is broken down at a slower rate in the body.

“Many people with type 1 diabetes struggle to regulate their blood sugar levels around mealtimes, because the fat content in their food is metabolized after their standard insulin injection has lost its potency or has left their blood,” said Dr. Matthew Campbell from Leeds Beckett University and co-author of the study. “Most meals in a typical UK diet have a high fat content, and slower metabolism of this fat can lead to raised blood sugar levels–with risk of hyperglycemia–and also higher levels of fat and inflammatory markers in the blood, which increase the risk of cardiovascular disease.”

The trial was held at the National Institute for Health Research (NIHR) Newcastle Clinical Research Facility. Ten men with type 1 diabetes were given 3 meals with identical carbohydrate and protein content. One of the meals had a low fat content, and two had a high fat content.

For the low-fat meal and one of the high-fat meals, the volunteers administered their usual insulin dose calculated using the carbohydrate level of the food. Three hours after the second high-fat meal, they administered an additional dose of insulin that was one-third the potency of their typical dose.

Blood samples were obtained every half hour for 6 hours following meals.

Data showed that for the high-fat meal and standard insulin injection, the sugar, fat, and inflammatory markers in the blood were significantly elevated 6 hours later. For the meal with the additional dose of insulin, blood analysis showed normal levels of sugar, fat, and inflammatory markers—similar to the levels following the low-fat meal.

“Improving the sugar and fat levels in the blood after eating is important for the long-term health of the heart and blood vessels, said co-author Dr. Daniel West, of Newcastle University. “But calculating insulin injection dose based on carbohydrates alone is clearly too simplistic, as most people eat meals that include fat and protein too.”

Dr. Campbell also noted that advice given to patients with type 1 diabetes should be updated to include this new information. “Our findings show that, after a high fat meal, an extra dose of insulin provides a very simple way of both regulating blood sugar levels for short term health and protecting against the long-term risks of cardiovascular disease,” he said.

The research team is now looking to continue with a larger trial over a longer period to look at blood vessel health and diabetes control.

To read more about this study, click here.

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