Dietary Fat and Protein Intake and Their Impact on Glycemic Control in Pediatric Type 1 Diabetes: A Narrative Review

Carbohydrates have been the center of type 1 diabetes dietary management. Emerging evidence highlights the important effects of fat and protein in postprandial hyperglycemia, suggesting that an increase in daily fat and protein intake, combined with appropriate insulin dose adjustments, might lead to better glycemic control. It is well studied that meals containing fat or protein lead to late postprandial hyperglycemia. Studies that researched the use of these macronutrients observed the need for extended or dual wave boluses to achieve euglycemia and that no consistent improvement in HbA1c or time in range was related to higher protein or fat intake. Optimizing glycemic control in pediatric T1D requires strategies beyond carbohydrate counting. While balanced macronutrient distribution remains the main solid factor in stable glycemic profiles, more studies regarding the variety of macronutrients' formulation in optimizing glycemic control are needed.