This content originally appeared on diaTribe. Republished with permission.

By Michael Howerton

What number of carbohydrates do you have to eat for ideal health with type 1 diabetes? It’s a matter that evades a straightforward answer. With diabetes nutrition, as with most things, one size doesn’t fit all, in keeping with two latest studies.

On the “Are We What We Eat?” symposium on the EASD 2023 conference in Hamburg, Germany, two nutrition researchers presented latest data that attempted to, if not answer the query of what the perfect weight loss plan ought to be for those with type 1 diabetes, not less than suggest ways to expand the conversation to make it more inclusive.

Dr. Hana Kahleova, director of clinical research on the Physicians Committee for Responsible Medicine in Washington D.C., presented findings of a study of a plant-based weight loss plan versus a regular portion-controlled weight loss plan for those with type 1 diabetes. Since insulin dependence is linked to a decreased life span, she said her aim was to search out a option to lower the quantity of insulin needed for individuals with type 1 diabetes through nutrition.

Kahleova cited the Diabetes Control and Complications Trial (DCCT) that documented over 30 years that higher insulin doses in individuals with type 1 diabetes were related to the next body mass index, higher pulse rate, and impaired blood lipids. The implications have been devastating, she noted, as each increase of 0.1 units/kg/day of insulin dose was related to a 6% increase in heart problems.

“Is there anything we are able to do to deal with this with nutrition?” Kahleova asked. “Can we actually lower the insulin dose with nutrition?”

The present recommendations for type 1 diabetes are portion control, carbohydrate counting, and minimizing the consumption of processed foods and sugar-sweetened beverages, with the bolus insulin dose calculated based on the carbohydrate content of the meal. Kahleova said hundreds of patients reported that different meals with similar carb levels affected them in a different way, resulting in a terrific deal of confusion and frustration.

“We all know that every one carbohydrates are usually not created equal,” she said. “There’s also loads of variability by way of fat and protein content and fiber content. The fiber content of the meals appears to be one of the vital crucial facets for individuals with type 1 diabetes.”

The common American consumes 16 grams of fiber a day, only half the really useful every day amount. The common in Europe is a bit higher with about 20 grams a day, but still not near enough. One other study has shown that 30-35 grams of fiber a day was related to a discount in all-cause mortality by about 15% compared with low-fiber intake.

“Fiber in diabetes has a rather more essential role to people than for the overall population,” Kahleova said, adding that for those with diabetes, each type 1 and sort 2, the all-cause mortality from fiber deficiency could be as much as 45%, and 39% for heart problems.

“We all know that a plant-based weight loss plan has been shown to be helpful in type 2 diabetes, improving insulin sensitivity in addition to improving beta cell function in chubby individuals with no diabetes,” she said, adding she was curious if the identical advantages were possible for those with type 1.

Kahleova said this small study, consisting of 58 individuals with type 1 diabetes, was the primary plant-based weight loss plan trial taking a look at insulin resistance for individuals with type 1 diabetes, adding that more work now must be done to follow up on the encouraging results.

The study found:

• Energy intake didn’t change significantly in either group from the beginning to the top of the trial period. Within the vegan group, the carbohydrate intake increased from about 200 g to 300 g a day, while the fat content went all the way down to keep the calories consistent. Within the portion-controlled group, the macronutrient ratio stayed regular.
• Total every day insulin dose didn’t change within the portion-control group, nevertheless it did decrease significantly, by 12.1 units a day, or a 28% drop, within the vegan group.
• Insulin sensitivity didn’t change significantly within the portion-control group, nevertheless it increased within the vegan group by 144%.
• A1C decreased in each groups. It decreased by 0.6% within the portion-control group and by 0.8% within the vegan group.
• Body weight didn’t change within the portion-control group, nevertheless it did decrease by 11.5 kilos on the vegan weight loss plan.
• Total cholesterol dropped significantly on each diets, nevertheless it decreased more on the vegan weight loss plan. LDL levels of cholesterol were reduced only on the vegan weight loss plan.
• Kidney function improved on the vegan weight loss plan over the portion-control weight loss plan.

“It is a novel approach for individuals with type 1 diabetes,” she told diaTribe concerning the study. “At first, it could appear intimidating to eat so many carbohydrates, but crucial aspect is that when people want to do that weight loss plan, they should keep the fat content low. That you must pick which shall be your fundamental fuel.”

Sofia Sterner Isaksson, of the University of Gothenburg, Sweden, presented a distinct study taking a look at various carbohydrate ratios in diets for type 1 diabetes to judge the results of carbohydrate intake on glucose control. Her team compared a moderate-level carbohydrate weight loss plan (by which 30% of the day’s energy got here from carbohydrates) with a standard weight loss plan (by which half of the day’s calories got here from carbohydrates).

The small study, taking a look at 50 individuals with type 1 diabetes, found that those on the moderate carbohydrate weight loss plan had higher glucose control. The group on the moderate carbohydrate weight loss plan also had a greater average time in range, by 5%, and fewer time above range, by 6.4%. Also notable, she said, was a reported higher treatment satisfaction rate for the moderate group. There was no increased risk for hypoglycemia, dyslipidemia, ketoacidosis or elevated blood pressure between the 2 weight loss plan groups.

“These results indicate that a moderate carbohydrate weight loss plan might be an efficient and protected weight loss plan option for some individuals with type 1 diabetes,” Sterner Isaksson said. “Each diets were individualized by a dietitian and were healthy, and this was essential in order to not negatively impact other health markers like weight, blood pressure or lipids.”

Reflecting on the info presented earlier by Kahleova, Sterner Isaksson told diaTribe after the panel discussion that it was clear that there was a couple of way for individuals with type 1 diabetes to eat in ways in which supported their health and diets ought to be individualized.

“It’s essential to have several types of diets that fit with different individuals,” she said. “Lowering the quantity of carbohydrates could fit for some people, but a plant-based weight loss plan with higher carbohydrate content with loads of fibers could work higher for others. That’s the reason it’s so nice to see latest studies investigating diets in type 1 diabetes.“