Background: Hybrid Closed-Loop Systems (HCLs) may not perform optimally on postprandial glucose control. We evaluated how first-generation and advanced HCLs manage meals varying in carbohydrates, fat, and protein. Method: According to a cross-sectional design, seven-day food records and HCLs reports from 120 adults with type 1 diabetes (MiniMed670G: n = 40, MiniMed780G: n = 49, Control-IQ [C-IQ]: n = 31) were analyzed. Breakfasts (n = 570), lunches (n = 658), and dinners (n = 619) were divided according to the median of their carbohydrate (g)/fat (g) plus protein (g) ratio (C/FP). After breakfast (4-hour), lunch (6-hour), and dinner (6-hour), continuous glucose monitoring (CGM) metrics and early and late glucose incremental area under the curves (iAUCs) and delivered insulin doses were evaluated. The association of C/FP and HCLs with postprandial glucose and insulin patterns was analyzed by univariate analysis of variance (ANOVA) with a two-factor design. Results: Postprandial glucose time-in-range 70 to 180 mg/dL was optimal after breakfast (78.3 ± 26.9%), lunch (72.7 ± 26.1%), and dinner (70.8 ± 27.3%), with no significant differences between HCLs. Independent of C/FP, late glucose-iAUC after lunch was significantly lower in C-IQ users than 670G and 780G ( P < .05), with no significant differences at breakfast and dinner. Postprandial insulin pattern (Ins _3-6h minus Ins _0-3h ) differed by type of HCLs at lunch ( P = .026) and dinner ( P < .001), being the early insulin dose (Ins _0-3h ) higher than the late dose (Ins _3-6h ) in 670G and 780G users with an opposite pattern in C-IQ users. Conclusions: Independent of different proportions of dietary carbohydrates, fat, and protein, postprandial glucose response was similar in users of different HCLs, although obtained through different automatic insulin delivery patterns.

Background/objectives Adherence to dietary recommendations is a critical component in the management of type 1 diabetes (T1D). Taste and flavor significantly influence food choices. The aim of this study was to investigate taste sensitivity and flavor recognition ability in adults with T1D compared to healthy individuals. Subjects/methods Seventy-two people with T1D and 72 matched healthy controls participated in the study. Participants underwent the gustometry test for sweet, sour, salty, and bitter tastes and the flavor test, which consisted of oral administration of aqueous aromatic solutions identifying 21 different compounds. Results Participants with T1D had significantly lower flavor scores and gustometry scores than controls (p < 0.0001 and p = 0.0063, respectively). T1D individuals showed a lower perception of sour, bitter and salty tastes than controls, while the perception of sweet taste was similar. The sex differences and age-related decline in flavor perception observed in controls were not present in the participants with T1D. Neither BMI nor disease-related parameters such as fasting blood glucose on the day of the study, glycosylated hemoglobin, age at onset of diabetes, duration of diabetes, or type of insulin treatment (insulin pump or multiple daily injections) correlated with flavor and taste perception in the T1D participants. Conclusions Flavor and taste perception are impaired in adults with T1D, potentially affecting dietary adherence and food choices. This highlights the need for further research into the mechanisms underlying sensory changes in T1D and emphasizes the importance of targeted dietary interventions to improve health outcomes and quality of life in this population.

Background. High blood concentrations of triglycerides (TG) in the postprandial period have been shown to be more closely associated with the risk of cardiovascular disease (CVD) than fasting values in individuals with type 2 diabetes (T2D). Dietary changes are the primary determinants of postprandial lipid responses. Methods. We investigated the effects of an isocaloric multifactorial diet, rich in n-3 PUFA, MUFA, fiber, polyphenols, and vitamins, compared to an isocaloric diet, containing the same amount of MUFA, on the postprandial lipid response in T2D individuals. Following a randomized, controlled, parallel group design, 43 (25 male/18 female) T2D individuals were assigned to an isocaloric multifactorial (n = 21) or a MUFA-rich diet (n = 22). At the beginning and after the 8 weeks of dietary intervention, the concentrations of plasma triglycerides, total cholesterol, HDL cholesterol, and non-HDL cholesterol were detected at fasting and over a 4-h test meal with the same composition as the prescribed diet. Results. The concentrations of fasting plasma triglycerides, total cholesterol, HDL cholesterol, and non-HDL cholesterol did not change after both diets. Compared with the MUFA diet, the 8-week multifactorial diet significantly lowered the postprandial response, which was evaluated as the incremental area under the curve (iAUC), of triglycerides by 33% (64 ± 68 vs. 96 ± 50 mmol/L·240 min, mean ± SD, respectively, p = 0.018), total cholesterol by 105% (−51 ± 33 vs. −25 ± 29, p = 0.013), and non-HDL cholesterol by 206% (−39 ± 33 vs. −13 ± 23, p = 0.013). Conclusions. In T2D individuals, a multifactorial diet, characterized by several beneficial components, improved the postprandial lipid response compared to a MUFA diet, generally considered a healthy diet being reduced in saturated fat, and probably contributed to the reduction of cardiovascular risk.

Background and objectives: Sleep disorders are bidirectionally linked with eating behaviors and glucose metabolism, and this could be clinically relevant in type 1 diabetes (T1D). We investigated the relationship between dietary habits and sleep quality in T1D. Methods: According to a cross-sectional design, T1D patients, 60 men and 60 women, aged 19–79, using continuous glucose monitoring (CGM) filled-in a 7-day food diary and completed the European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire on dietary habits and the Pittsburgh Sleep Quality Index (PSQI) questionnaire on sleep quality. Blood glucose values over 6 h after dinner were registered for one week. Differences in dietary habits and blood glucose were compared between the participants with good/bad quality, long/short duration, and long/short onset latency of sleep. Results: Bad sleepers (n = 84) were twice as prevalent as good sleepers (n = 36) and had significantly higher intake of fat than good sleepers, in particular at dinner time (30.7 ± 10.7 vs. 24.0 ± 10.5 g, p = 0.004). Short sleepers had significantly higher usual intake (g/1000 kcal) of coffee and tea (88.7 ± 70.9 vs. 62.0 ± 35.6), alcoholic beverages (46.6 ± 50.4 vs. 28.9 ± 31.5), and carbonated soft beverages (21.0 ± 37.5 vs. 9.3 ± 17.2) (p < 0.05 for all). Compared with the short sleep onset latency participants, the long sleep onset latency participants had significantly higher intake of fat at dinner time (41.8 ± 7.4 vs. 38.1 ± 9.1% total energy, p = 0.029). No differences in post-dinner blood glucose were detected between the participants with bad or good sleep quality. Discussion: Sleep disruption is common in T1D and is associated with unhealthy dietary choices, especially at dinner time, independently of post-dinner blood glucose control.