TOPLINE

A higher intake of ultraprocessed foods (UPFs) was associated with an atherogenic lipid profile — higher triglyceride levels and lower high-density lipoprotein (HDL) cholesterol levels — in adults with type 1 diabetes (T1D). Specific UPF subgroups, including processed meats and sugar- or artificially sweetened beverages, were associated with these lipid changes, and ready-to-eat dishes were linked to poorer glycaemic control in patients using multiple daily injections or open-loop insulin therapy.

METHODOLOGY

• Researchers in Italy conducted a cross-sectional study to assess the association between UPF intake and glycaemic control, major cardiovascular risk factors, and the gut microbiome in patients with T1D.
• They analysed data of 253 adults with T1D (mean age, 38.9 years; 49% men; mean diabetes duration, 22.4 years) who used continuous glucose monitoring (CGM) systems.
• Dietary intake over the previous 12 months was assessed using a validated food frequency questionnaire, and UPFs were grouped into nine categories on the basis of nutritional characteristics and their contribution to the total UPF intake.
• Lipid profile (total cholesterol, HDL cholesterol, and triglyceride levels) and A1c levels were evaluated; CGM metrics from the 14 days preceding the study visit were also assessed.
• A subgroup of 103 patients provided stool samples for microbiome analysis.

TAKEAWAY

• The mean UPF intake was 226.1 g/d, reflecting 15.5% of the total food intake; in the adjusted analysis, each 20 g/1000 kcal increase in the UPF intake was associated with higher triglyceride levels (beta-coefficient, 3.62 mg/dL; 95% CI, 1.16-6.08) and lower HDL cholesterol levels (beta-coefficient, -0.98 mg/dL; 95% CI, -1.72 to -0.24).
• Beverages with added sugars or artificial sweeteners were positively associated with triglyceride levels. Animal-based UPFs, particularly processed meats, were inversely associated with HDL cholesterol levels.
• Among participants using multiple daily injections or open-loop insulin therapy, ready-to-eat or ready-to-heat mixed dishes were positively associated with A1c levels.
• Microbiome beta-diversity differed significantly by UPF intake (P < .01), with an intake of sugar- or artificially sweetened beverages positively associated with Coprococcus comes and negatively associated with Anaerotruncus massiliensis.

IN PRACTICE

"Our findings suggest that the reduction of some UPF — processed meats and sweetened beverages — should be emphasized in nutritional guidance for individuals with T1D. In clinical practice, soft drinks should be reserved for hypoglycemia treatment and used in the smallest effective amounts," the authors wrote.

SOURCE

The study was led by Jumana Abuqwider, University of Naples Federico II, Naples, Italy. It was published online on June 24, 2026, in Diabetes Research and Clinical Practice.

LIMITATIONS

The study was limited by its cross-sectional design, the modest sample size for the microbiome analysis, and the use of the food frequency questionnaire that could not distinguish between sugar-sweetened and artificially sweetened beverages. Moreover, the use of different CGM systems may have introduced heterogeneity in glucose measurements.

DISCLOSURES

This work was supported by the Italian Ministry of Education, University and Research and the Department of Clinical Medicine and Surgery of the Federico II University Hospital. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.