Wolpert, Howard A.

Diabetes Care

Harvard University - DASH 

 Response to Comment on: Wolpert et al. Dietary Fat AcutelyIncreases Glucose Concentrations and Insulin Requirements inPatients With Type 1 Diabetes: Implications for Carbohydrate-Based Bolus Dose Calculation and Intensive DiabetesManagement. Diabetes Care 2013;36:810–816  (Article begins on next page)The Harvard community has made this article openly available.Please share how this access benefits you. Your story matters.Citation Wolpert, Howard A. 2013. “Response to Comment on: Wolpertet al. Dietary Fat Acutely Increases Glucose Concentrations andInsulin Requirements in Patients With Type 1 Diabetes:Implications for Carbohydrate-Based Bolus Dose Calculationand Intensive Diabetes Management. Diabetes Care2013;36:810–816.” Diabetes Care 36 (12): e212.doi:10.2337/dc13-1464. http://dx.doi.org/10.2337/dc13-1464.Published Version doi:10.2337/dc13-1464Accessed February 17, 2015 8:07:58 AM ESTCitable Link http://nrs.harvard.edu/urn-3:HUL.InstRepos:13581127Terms of Use This article was downloaded from Harvard University's DASHrepository, and is made available under the terms and conditionsapplicable to Other Posted Material, as set forth athttp://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACOMMENTS ANDRESPONSESResponse toComment on:Wolpertetal.DietaryFat Acutely IncreasesGlucoseConcentrations andInsulinRequirementsin Patients WithType 1 Diabetes:Implications forCarbohydrate-BasedBolus DoseCalculation andIntensive DiabetesManagement.Diabetes Care2013;36:810–816We appreciate the comment ofWolever (1) regarding our study(2) and that we performed amuch more detailed, well-controlled, andsophisticated study. We also appreciatethe comment regarding the details aboutthe composition of the test meals in thestudy. Thus, to allow comparison of ourresults with others in the literature, weprovide the following clariﬁcations. Themean weights of carbohydrates, protein,and dietary ﬁber in the dinner test mealswere as follows: low-fat dinner, 96.9 g,41.3 g, and 10.9 g, respectively; high-fatdinner,96.4g,41.3g,and10.4g,respec-tively. Breakdown of the fatty acid con-tent in the high-fat dinner was as follows:28.9 g saturated, 17.6 g monounsatu-rated, and 8.4 g polyunsaturated. Meanweights of the various foods were as fol-lows: low-fat dinner, chicken 98 g, rice160 g, broccoli 96 g, grapes 127 g; high-fat dinner, cheese 74 g, chicken 39 g,white bread 63 g, croutons 32 g, oranges216g.Itisnoteworthythatarecentstudy(3) demonstrated that higher-fat mealscontaining 35 g of fat (a quantity inter-mediate between that given in Wolevera n dM u l l a n[ 4 ]a n do u r[ 2 ]s t u d y )c a u s elate postprandial hyperglycemia in chil-dren with type 1 diabetes. This increasein the glucose excursions occurs approx-imately3–5hpostmeal,alsohighlightingthat meal-challenge tests need to be ofsufﬁcient duration to uncover the glyce-mic effect of dietary fat.HOWARD A. WOLPERT, MDFrom the Joslin Diabetes Center and Harvard Med-ical School, Boston, Massachusetts.Corresponding author: Howard A. Wolpert,howard.wolpert@joslin.harvard.edu.DOI: 10.2337/dc13-1464© 2013 by the American Diabetes Association.Readers may use this article as long as the work isproperly cited, the use is educational and not forproﬁt, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ fordetails.Acknowledgments—Nopotentialconﬂictsofinterest relevant to this article were reported.ccccccccccccccccccccccccReferences1. Wolever TMS. Comment on: Wolpert et al.Dietary fat acutely increases glucose con-centrations and insulin requirements in pa-tients with type 1 diabetes: implications forcarbohydrate-based bolus dose calculationand intensive diabetes management. Diabe-tes Care 2013;36:810–816 (Letter). DiabetesCare 2013;36:e211. DOI: 10.2337/dc13-11732. Wolpert HA, Atakov-Castillo A, Smith SA,Steil GM. Dietary fat acutely increases glu-cose concentrations and insulin require-ments in patients with type 1 diabetes:implications for carbohydrate-based bolusdose calculation and intensivediabetes man-agement. Diabetes Care 2013;36:810–8163. SmartCE,DavisE,KingBR,etal.Bothpro-tein and fat increase postprandial glucoseexcursions in children with type 1 diabetesand the effect is additive. Diabetes 2013;62(Suppl. 1):A414. Wolever TMS, Mullan YM. Sugars and fathave different effects on postprandial glu-cose responses in normal and type 1 dia-betic subjects. Nutr Metab Cardiovasc Dis2011;21:719–725e212 DIABETES CARE, VOLUME 36, DECEMBER 2013 care.diabetesjournals.orgONLINE LETTERS

Response to Comment on: Wolpert et al. Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes: Implications for Carbohydrate-Based Bolus Dose Calculation and Intensive Diabetes Management. Diabetes Care 2013;36:810–816

http://dash.harvard.edu/bitstream/handle/1/13581127/3836089.pdf?sequence=1

Response to Comment on: Wolpert et al. Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes: Implications for Carbohydrate-Based Bolus Dose Calculation and Intensive Diabetes Management. Diabetes Care 2013;36:810–816

Abstract

Similar works

Full text

Available Versions

Harvard University - DASH