606-P: The Effect of a Dietary Intervention on Insulin Requirements in Type 1 Diabetes—A 12-Week Randomized Clinical Trial

Abstract

Background and Objective: A plant-based has been shown to improve glycemic control and insulin resistance in people with type 2 diabetes. The aim of this study was to test the effect of this diet in people with type 1 diabetes. Methods: Fifty-eight people with type 1 diabetes were randomly assigned to follow a low-fat vegan diet (vegan group, n=29), or a standard portion-controlled diet (control group, n=29) for 12 weeks. All meals were tracked, using the Cronometer mobile application. Insulin sensitivity was assessed, using the carbohydrate to insulin ratio, which was calculated as the number of grams of total dietary carbohydrate to total units of insulin administered. Total insulin dose was calculated as a sum of basal and bolus insulin units injected per day. Results: The consumption of carbohydrates increased in the vegan group by an average of 118 g/day (p=0.002), compared with no significant change in the control group (−18 g/day; p=0.11; treatment effect +137 [95% CI, +65 to +208]; p<0.001). Insulin sensitivity, assessed by the carbohydrate to insulin ratio, increased in the vegan group by 6.2 on average (p=0.002), compared with no significant change in the control group (−0.8; p=0.32; treatment effect +7.0 [95% CI, +3.1 to +10.9]; p=0.001). Total daily dose of insulin decreased by 12.1 units/day in the vegan group (p=0.007), compared with no significant change in the control group (−18 units/day; p=0.66; treatment effect −10.7 [95% CI, −21.3 to −0.2]; p=0.046). Conclusions: This study suggests that a low-fat vegan diet may have beneficial effects on insulin sensitivity and insulin requirements in people with type 1 diabetes. Larger trials are needed to confirm these findings. Trial Registration: ClinicalTrials.gov, NCT04944316 Disclosure H.Kahleova: None. Funding Physicians Committee for Responsible Medicine (330072)