Key result
Low Mediterranean diet adherence linked to higher arterial stiffness and vascular dysfunction in type 1 diabetes.
Why the study?
The Mediterranean diet improves cardiometabolic risk, but its impact on type 1 diabetes management and subclinical endothelial, myocardial, and vascular function in adults using hybrid closed-loop insulin delivery systems remains understudied.
Does higher adherence to the Mediterranean diet improve glucose/insulin metrics and subclinical markers of endothelial, myocardial, and vascular function in adults with type 1 diabetes using hybrid closed-loop systems?
Cross-Sectional (n=90)
Does higher adherence to the Mediterranean diet improve glucose/insulin metrics and subclinical markers of endothelial, myocardial, and vascular function in adults with type 1 diabetes using hybrid closed-loop systems?
In adults with type 1 diabetes on hybrid closed-loop insulin therapy, low adherence to the Mediterranean diet is associated with increased arterial stiffness and impaired endothelial and myocardial function despite similar glycemic control.
Background The Mediterranean diet (MD) improves cardiometabolic risk. However, its impact on type 1 diabetes (T1D) management remains understudied. Purpose We aim to evaluate the association of adherence to MD in adults with T1D using hybrid closed loop insulin deliver system (HCLS) with glucose, insulin metrics, and subclinical markers of endothelial, myocardial and vascular function. Methods In 90 adults with T1D using the MiniMedTM-780G system we evaluated: (a) adherence to the MD, using the Mediterranean Diet Adherence Screener (MEDAS); (b) glucose and insulin metrics, via CareLink™Clinic software and assessment of time in range within normal glucose levels (TIR); vascular function via pulse wave velocity (PWV); (d) the perfused boundary region (PBR) of the sublingual arterial microvessels, as a marker of endothelial glycocalyx integrity; and (e) myocardial function via left ventricular global longitudinal strain (LVGLS). Results The mean HbA1C and BMI was 6.98±0.63% and 26.7 ± 5.0 kg/m2 respectively. We stratified the participants in three MD score categories: 21(23.33%) patients presented with low adherence (LA), 55(61.11%) with moderate adherence(MA) and 14 (15.55%) with high adherence(HA). HbA1c time in range within normal glucose levels (TIR) did not significantly differ between groups (p>0.05).Compared to MA and HA group, the LA group showed higher auto-correction boluses (9.87±5.64IU vs 7.05±4.77IU vs 14.34±12.07IU respectively, p=0.015), PWV(9.08±3.39 vs 8.75±2.51 vs 11.57±4.36m/s respectively, p=0.017), PBR4-25 (2.17±0.20 vs 2.08±0.13 vs 2.26±0.15μm respectively, p=0.022) and LV GLS(-18.74±2.34 vs -20.82±2.11 vs -18.95±2.38% respectively, p=0.017). Conclusions A lower adherence to MD is associated with increased arterial stiffness and impaired endothelial and myocardial function, regardless of effective glycemic control by use of hybrid closed loop insulin deliver system
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Thymis et al. (2026) conducted a cross-sectional in Type 1 diabetes (n=90). Low Mediterranean diet adherence vs. Moderate and high Mediterranean diet adherence was evaluated on Subclinical markers of vascular, endothelial, and myocardial function (PWV, PBR4-25, and LV GLS) and insulin metrics (p=0.017). Low Mediterranean diet adherence was associated with higher pulse wave velocity (11.57 vs 9.08 and 8.75 m/s, p=0.017) and impaired endothelial and myocardial function in T1D on hybrid closed-loop.
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