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Abstract Aims/hypothesis The aim of this work was to investigate the association between macronutrient intakes and continuous glucose monitoring (CGM) metrics in individuals with type 1 diabetes. Methods In 470 individuals with type 1 diabetes of the GUTDM1 cohort (65% female, median age 40 IQR 28–53 years, median diabetes duration 15 IQR 6–29 years), we used logistic regression to establish associations between macronutrient intakes and the CGM metrics time in range (TIR, time spent between 3.9–10.0 mmol/l blood glucose, optimally set at ≥70%) and time below range (TBR, <3.9 mmol/l blood glucose, optimally set at <4%). ORs were expressed per 1 SD intake of nutrient and were adjusted for other macronutrient intakes, age, sex, socioeconomic status, BMI, duration of type 1 diabetes, pump use, insulin dose and alcohol intake. Results The median (IQR) TIR was 67 (51–80)% and TBR was 2 (1–4)%; the mean ± SD energy intake was 6879±2001 kJ, fat intake 75±31 g, carbohydrate intake 162±63 g, fibre intake 20±9 g and protein intake 70±24 g. A higher fibre intake and a lower carbohydrate intake were associated with higher odds of having a TIR≥70% (OR 95% CI 1.64 1.22, 2.24 and 0.67 0.51, 0.87, respectively), whereas solely a higher carbohydrate intake was associated with TBR<4% (OR 1.34 95% CI 1.02, 1.78). Conclusions/interpretation A higher fibre intake is independently associated with a higher TIR. A higher carbohydrate intake is associated with less time spent in hypoglycaemia, a lower TIR and a higher time above range. These findings warrant confirmatory (interventional) investigations and may impact current nutritional guidelines for type 1 diabetes. Graphical Abstract
Wit et al. (Fri,) studied this question.