A one-week reduced-carbohydrate diet to mitigate iatrogenic peripheral hyperinsulinemia does not improve insulin sensitivity or endothelial function in a randomized, crossover trial in patients with type 1 diabetes
Authors' conclusion
Although a one-week RCD significantly lowered insulin requirements, it failed to enhance insulin sensitivity or endothelial function in adults with type 1 diabetes. These findings underscore the complex and dynamic relationship between insulin exposure and cardiometabolic health. Similar basal overnight insulin delivery may have masked potential benefits by the time of testing, highlighting the need for further studies to refine strategies aimed at mitigating hyperinsulinemia's adverse effects.
Study context
- Population
- Adults with T1Dcrossover, 3-week washout
- Participants
- 12 adults
- Comparison
- One-week reduced-carbohydrate diet (RCD) vs isocaloric standard carbohydrate diet (SCD)
- Primary endpoint
- Insulin sensitivity (hyperinsulinemic-euglycemic clamp glucose infusion rate) and endothelial function (brachial-artery FMD)
- Follow-up
- After each one-week intervention
Methodological detailscrossover, single-blinded
- Crossover
- Single-blinded
Primary result
As reported in the abstract
Insulin sensitivity: glucose infusion rate
P = 0.47
Further findings
| Outcome | RCD | SCD | P value |
|---|---|---|---|
| Endothelial function: FMDDid not differ significantly | 7.50% (IQR 3.25–15.5) | 9.81% (IQR 4.96–14.3) | P = 0.91 |
Total daily insulin dose
- RCD reduced total daily insulin doses vs SCD
- 16%
Insulin dose and insulin sensitivity
- Higher insulin doses correlated with lower insulin sensitivity under both conditions
Original publication
A one-week reduced-carbohydrate diet to mitigate iatrogenic peripheral hyperinsulinemia does not improve insulin sensitivity or endothelial function in a randomized, crossover trial in patients with type 1 diabetes. Cardiovasc Diabetol. Published 5 March 2025. doi:10.
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