Diabetes Type 1 and 2

DM: Types of Fat (2014)

• Intervention
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, on glycemia (A1C or glucose)?

  • Conclusion

    Studies regarding the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, reported no significant effect on A1C or glucose levels in adults with type 1 and type 2 diabetes.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, on glycemia (A1C or glucose)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Delahanty LM, Nathan DM, Lachin JM, Hu FB, Cleary PA, Ziegler GK, Wylie-Rosett J, Wexler DJ, Diabetes Control and Complications Trial/Epidemiology of Diabetes. Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial. Am J Clin Nutr. 2009; 89 (2): 518-524.
      • Dullaart RP, Beusekamp BJ, Meijer S, Hoogenberg K, van Doormaal JJ, Sluiter WJ. Long-term effects of linoleic-acid-enriched diet on albuminuria and lipid levels in type 1 (insulin-dependent) diabetic patients with elevated urinary albumin excretion. Diabetologia. 1992; 35(2): 165-172.
      • Heine RJ, Mulder C, Popp-Snijders C, van der Meer J, van der Veen EA. Linoleic-acid-enriched diet: Long-term effects on serum lipoprotein and apolipoprotein concentrations and insulin sensitivity in noninsulin-dependent diabetic patients. Am J Clin Nutr. 1989; 49(3): 448-456.
      • Jenkins DJ, Kendall CW, Banach MS, Srichaikul K, Vidgen E, Mitchell S, Parker T, Nishi S, Bashyam B, de Souza R, Ireland C, Josse RG. Nuts as a replacement for carbohydrates in the diabetic diet. Diabetes Care. 2011; 34: 1,706-1,711.  
      • Strychar IS, Cohn JS, Renier G, Rivard M, Aris-Jilwan N, Beauregard H, Meltzer S, Belanger A, Dumas R, Ishac A, Radwan F, Yale J-F: Effects of a diet higher in carbohydrate/lower in fat versus lower in carbohydrate/higher in monounsaturated fat on postmeal triglyceride concentrations and other cardiovascular risk factors in type 1 diabetes. Diabetes Care, 2009; 32: 1,597-1,599.
      • Wolever TM, Gibbs AL, Mehling C, Chiasson JL, Connelly PW, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr. 2008; 87 (1): 114-125.
  • Search Plan and Results: DM: Type of Fat 2013
     
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, on insulin levels (exogenous or endogenous)?

  • Conclusion
    Four studies regarding the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, reported no significant effect on exogenous insulin doses in adults with type 1 diabetes and no significant effect on endogenous insulin levels in adults with type 2 diabetes.
  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, on insulin levels (exogenous or endogenous)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dullaart RP, Beusekamp BJ, Meijer S, Hoogenberg K, van Doormaal JJ, Sluiter WJ. Long-term effects of linoleic-acid-enriched diet on albuminuria and lipid levels in type 1 (insulin-dependent) diabetic patients with elevated urinary albumin excretion. Diabetologia. 1992; 35(2): 165-172.
      • Heine RJ, Mulder C, Popp-Snijders C, van der Meer J, van der Veen EA. Linoleic-acid-enriched diet: Long-term effects on serum lipoprotein and apolipoprotein concentrations and insulin sensitivity in noninsulin-dependent diabetic patients. Am J Clin Nutr. 1989; 49(3): 448-456.
      • Strychar IS, Cohn JS, Renier G, Rivard M, Aris-Jilwan N, Beauregard H, Meltzer S, Belanger A, Dumas R, Ishac A, Radwan F, Yale J-F: Effects of a diet higher in carbohydrate/lower in fat versus lower in carbohydrate/higher in monounsaturated fat on postmeal triglyceride concentrations and other cardiovascular risk factors in type 1 diabetes. Diabetes Care, 2009; 32: 1,597-1,599.
      • Wolever TM, Gibbs AL, Mehling C, Chiasson JL, Connelly PW, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr. 2008; 87 (1): 114-125.
  • Search Plan and Results: DM: Type of Fat 2013
     
  In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, on CVD risk factors (lipids or blood pressure)?

  • Conclusion

    Six studies regarding the relationship of differing amounts of saturated and unsaturated fatty acids (independent of weight loss) reported no significant effect on triglyceride levels or blood pressure in adults with diabetes. However, research regarding differing amounts of saturated and unsaturated fatty acids on HDL-cholesterol reported mixed results. Modifications to decrease saturated fat intake and increase unsaturated fat intake reduced total and LDL-cholesterol in three studies and had no effect on total- and LDL-cholesterol in three studies.

    Subjects did not have or were not described as having any disorders of lipid metabolism or hypertension. Additional long-term studies are needed to ascertain the relationship of differing types of fat, independent of weight loss, on lipid profile in adults with diabetes, especially those with disorders of lipid metabolism and hypertension.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of saturated and unsaturated fatty acids, independent of weight loss, on CVD risk factors (lipids or blood pressure)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dullaart RP, Beusekamp BJ, Meijer S, Hoogenberg K, van Doormaal JJ, Sluiter WJ. Long-term effects of linoleic-acid-enriched diet on albuminuria and lipid levels in type 1 (insulin-dependent) diabetic patients with elevated urinary albumin excretion. Diabetologia. 1992; 35(2): 165-172.
      • Heine RJ, Mulder C, Popp-Snijders C, van der Meer J, van der Veen EA. Linoleic-acid-enriched diet: Long-term effects on serum lipoprotein and apolipoprotein concentrations and insulin sensitivity in noninsulin-dependent diabetic patients. Am J Clin Nutr. 1989; 49(3): 448-456.
      • Jenkins DJ, Kendall CW, Banach MS, Srichaikul K, Vidgen E, Mitchell S, Parker T, Nishi S, Bashyam B, de Souza R, Ireland C, Josse RG. Nuts as a replacement for carbohydrates in the diabetic diet. Diabetes Care. 2011; 34: 1,706-1,711.  
      • Strychar IS, Cohn JS, Renier G, Rivard M, Aris-Jilwan N, Beauregard H, Meltzer S, Belanger A, Dumas R, Ishac A, Radwan F, Yale J-F: Effects of a diet higher in carbohydrate/lower in fat versus lower in carbohydrate/higher in monounsaturated fat on postmeal triglyceride concentrations and other cardiovascular risk factors in type 1 diabetes. Diabetes Care, 2009; 32: 1,597-1,599.
      • Wolever TM, Gibbs AL, Mehling C, Chiasson JL, Connelly PW, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr. 2008; 87 (1): 114-125.
  • Search Plan and Results: DM: Type of Fat 2013