Diabetes: Extra dose of insulin after eating fatty foods

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To calculate the necessary insulin dose, diabetics use the carbohydrates in a meal as a guide. What many do not consider: Fat is also converted to a certain extent by the body into carbohydrates - and can thus drive blood sugar up. An additional dose of insulin three hours after a high-fat meal can compensate for this - and protect against cardiovascular disease in the long term.

Excessive blood sugar levels promote arteriosclerosis. People with type 1 diabetes are therefore ten times more likely to suffer a stroke, heart attack or other cardiovascular disease than people with a healthy sugar metabolism.

"Many type 1 diabetics have problems regulating their blood sugar levels after meals," says Mathew Campell of Leeds Becket University in the UK. The reason is that the fat content of the food is only slowly metabolized - including glucose, among other things. "At this point, however, the effect of the insulin has already waned," said the scientist.

Extra portion of insulin

As part of a small study, the researcher and his team have now investigated to what extent a delayed, additional insulin administration could protect against these dubious consequences of a high-fat diet. They also served three meals to ten men with type 1 diabetes. These contained the same amounts of carbohydrates and proteins, but only one of them was low in fat and the other two were high in fat. Three hours after one of the high-fat meals, the participants received additional insulin again - a third of the amount they had injected based on the carbohydrates it contained.

Lower blood sugar, less inflammation

Subsequent blood tests every half an hour showed that six hours after a high-fat meal, the blood sugar, but also blood lipid levels and inflammation markers in the blood were significantly increased - provided that no additional insulin was injected. In the long term, such values ​​damage the blood vessels and thus also the heart. After the extra dose of insulin, however, the values ​​did not climb any higher than after the low-fat meal.

"Calculating the amount of insulin that is necessary for the utilization of a meal based only on the carbohydrates it contains is a far too simplified approach," says Daniel West, co-author of the study. The scientists now want to review their findings as part of a larger and longer-term study.

Reduce long-term risks

"Our results show a very simple way to regulate blood sugar levels immediately and to protect the cardiovascular system in type 1 diabetics in the long term," says Campbell. The researchers are therefore already calling for the recommendations for type 1 diabetics to be adapted accordingly. However, they also emphasize that diabetics should discuss changes in insulin dosage with their doctor. In fact, excessive doses of insulin can cause dangerous hypoglycaemia.

Diabetes in Germany

In Germany alone, six million people live with diabetes. Of these, however, 90 percent suffer from type 2 diabetes, which is based on a completely different mechanism. While insulin production comes to a complete standstill in type 1 diabetics due to an autoimmune reaction, it is only reduced in type 2 diabetics, while the body cells are insensitive to the sugar-breaking hormone. Sometimes lifestyle changes can normalize their blood sugar levels or tablets are sufficient. Only some of them also need to inject insulin. The study does not provide any indication as to whether the additional administration of insulin after high-fat meals could also be useful for these patients.

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