Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2016

Metabolic effect of high-calorie meals on type 1 diabetic individuals with and without nephropathy (The FinnDiane Study) (#228)

Stefan Mutter 1 , Song Gao 1 , Antti J Kangas 2 , Pasi Soininen 2 3 , Carol Forsblom 4 5 6 , Per-Henrik Groop 4 5 6 , Mika-Ala Korpela 2 3 7 , Markku Lehto 4 5 6 , Ville-Petteri Mäkinen 1 2 8
  1. South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia
  2. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland
  3. NMR Metabolomics, University of Eastern Finland, Kuopio, Finland
  4. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
  5. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  6. Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
  7. School of Social and Community Medicine and the MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
  8. School of Biological Sciences, University of Adelaide, Adelaide, South Australia, Australia

Diet plays a key role in our health and the diversity of systemic responses to food intake may partly explain the complex patterns of metabolic dysfunction. This study investigated the postprandial effects of three consecutive high fat meals.

Participants were given high-calorie meals (2600kcal) at 8am (965kcal, 58% of total energy (E%) from fats), at 12pm (870kcal, 44E% fats) and 4pm (779kcal, 46E% fats). Blood samples were drawn at fasting (8am) and every two hours thereafter until 6pm and the following morning. Individuals with type 1 diabetes (T1D) (25 men and 27 women, mean age 44.3±10.2 years, average diabetes duration 28.7±13.4 years) and without (20 men and 21 women, mean age 37.0±11.2 years) were enrolled from the FinnDiane cohort including six individuals with T1D and microalbuminuria (MI, albumin excretion rate (AER) > 30mg/24h) and 10 with macroalbuminuria (MA, AER > 300 mg/24h). Albuminuria was based on three consecutive urine samples prior to the experiment.

Isoleucine and valine showed a consistent increase across all individuals (+50% and +28% median change from baseline) whereas VLDL triglycerides showed a large spread from +6% to 339% across individuals. On average, serum creatinine was stable (-5% median decrease), however, a maximal increase of +263% was observed in T1D compared to max +27% in the control group. At 6pm, T1D individuals with normal AER had the highest total cholesterol in large LDL particles (normal AER: 0.6, MI: 0.7 and MA: 0.8mmol/L, p = 0.03). For polyunsaturated FA, normal AER was also associated with the highest concentration at 6pm (normal AER: 5.5, MA: 4.6 and MI: 4.4mmol/L, p = 0.02).

There was substantial individual variation in metabolic meal responses but it was not attributed to T1D. Nevertheless, our results warrant further studies on how the diabetic kidney in particular responds to high-calorie meals in real-world settings.