Fat and protein counting in type 1 diabetes

Abstract

The prevalence of obesity in type 1 diabetes is increasing and may be exacerbated by the use of an intensive insulin therapy regimen which improves glycaemia but is associated with weight increase. There are a plethora of diets and weight loss programmes to choose from, but balancing the insulin doses to achieve good glycaemic control is challenging. Mealtime insulin doses are traditionally calculated to match the amount of carbohydrate in the meal but evidence, particularly from continuous glucose monitoring, suggests that protein and fat can also have an effect on postprandial glycaemia. This article looks at the effect of fat and protein on the glycaemic response of a meal, alternative algorithms to calculate the bolus doses, their timing and delivery, and considers their effectiveness in supporting weight loss in overweight or obese individuals with type 1 diabetes. Copyright © 2016 John Wiley & Sons.