Diabetes: Nutrition & Cardiometabolic Health | Andrew Koutnik, PhD | The Metabolic Link Ep.72

Jul 22, 2025

In this insightful discussion, Andrew Koutnik, a research scientist at the Sansom Diabetes Research Institute, sheds light on the surprising stagnation in blood sugar control for Type 1 diabetes despite technological advancements. He reveals groundbreaking findings on carbohydrate intake and its effects on glycemic management. Dr. Koutnik also explores the long-term safety of low-carb diets through a unique decade-long case study, emphasizing nutrition as a crucial, yet underutilized, tool in diabetes care and its impact on cardiovascular health.

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INSIGHT

Plateau of Glycemic Control

Despite advances in technology, glycemic control in people with Type 1 diabetes has plateaued or worsened since 2010.
This suggests technology alone is insufficient to improve long-term blood sugar outcomes for most patients.

INSIGHT

Type 1 Insulin Resistance Paradox

Type 1 diabetes patients suffer from insulin resistance similar to those with type 2 diabetes.
Peripheral hyperinsulinemia due to exogenous insulin contributes significantly to insulin resistance in type 1 diabetes.

INSIGHT

Carbohydrates Mostly Impact Blood Sugar

Carbohydrates are the most potent dietary factor impacting post-meal blood glucose and insulin load in Type 1 diabetes.
Fat minimally affects glycemic control while protein has a moderate effect on blood glucose.

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Despite incredible advances in diabetes technology, blood sugar control in people with Type 1 diabetes hasn’t meaningfully improved in over a decade. In this eye-opening episode recorded live at Metabolic Health Summit, Dr. Andrew Koutnik - a scientist, patient, and advocate - dives into the science behind this paradox.

Dr. Koutnik shares groundbreaking data from the largest-ever analysis of carbohydrate intake in people with Type 1 diabetes, explores the limitations of current technology, and presents a rare 10-year case study examining the long-term safety and efficacy of carbohydrate restriction.

From CGMs to closed-loop systems, from meal composition to insulin dosing, this episode challenges conventional assumptions and offers a compelling case for nutrition as a powerful - yet underutilized - tool in diabetes care.

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