Low-carbohydrate diets in type 1 diabetes: balancing benefits and risks

Hancock, Michael L.; Burns, Kharis; Gan, Seng Khee; Chew, Gerard T.

doi:10.1097/med.0000000000000797

Cited by 6 publications

(3 citation statements)

References 45 publications

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“…Indeed, these diets are associated with an increased risk of onset of complications such as hypoglycemia, DKA, dyslipidemia and a growth failure due to nutritional deficiencies, but also poor adherence due to reduced food choices. In addition, the adoption of this type of diet might also have behavioral repercussions by causing increased stress levels, which in turn would result in a worse glycemic control [ 74 , 75 , 76 , 77 ].…”

Section: Studies Focusing On Diets Characterized By Different Quantit...mentioning

confidence: 99%

Diet and Glycemic Index in Children with Type 1 Diabetes

et al. 2023

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In children with type 1 diabetes, a healthy lifestyle is important to control postprandial glycemia and to avoid hyperglycemic peaks that worsen the inflammatory state of vessels and tissues. Glycemic index and glycemic load are two important indexes which assess the quality and quantity of foods consumed during meals. The main macronutrients of the diet have a different effect on postprandial blood glucose levels, so it is important that diabetic children consume foods which determine a slower and steadier glycemic peak. In this review, we present the results of the most recent studies carried out in the pediatric population with T1D, whose aim was to analyze the effects of low-glycemic-index foods on glycemic control. The results are promising and demonstrate that diets promoting low-glycemic-index foods guarantee a greater glycemic stability with a reduction in postprandial hyperglycemic peaks. However, one of the main limitations is represented by the poor adherence of children to a healthy diet. In order to obtain satisfactory results, a possibility might be to ensure a balanced intake of low-, moderate- and high-glycemic-index foods, preferring those with a low glycemic index and limiting the consumption of the high- and moderate-glycemic-index types.

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Section: Studies Focusing On Diets Characterized By Different Quantit...mentioning

confidence: 99%

Diet and Glycemic Index in Children with Type 1 Diabetes

et al. 2023

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“…No studies have addressed the impact of a KD on skeletal health in individuals with type 1 diabetes, as far as we know. A recent review of low carbohydrate diets in type 1 diabetes noted a negative impact on growth in pediatric patients [47]. In many cases, the low carbohydrate diet was patient-determined and involved little to no clinical support, as a KD is not a standard therapeutic option for pediatric type 1 diabetes management.…”

Section: How Might a Ketogenic Diet Affect Skeletal Health?mentioning

confidence: 99%

Effects of very low carbohydrate ketogenic diets on skeletal health

Best¹,

Hsu

2023

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of reviewVery low carbohydrate ketogenic diet (KD) therapy has been associated with skeletal demineralization in children with drug-resistant epilepsy, but the cause of this association is unclear. Recently, interest in the KD has grown owing to its potential benefits for other illnesses including cancer, type 2 diabetes, obesity, and polycystic kidney disease. Summaries of the best available evidence regarding effects of a KD on skeletal health are lacking. Recent findingsRecent rodent studies found that a KD can harm the growing skeleton, which corroborates most but not all studies in pediatric patients. Proposed mechanisms include chronic metabolic acidosis and depressed osteoanabolic hormones. Relative to other weight-reducing diets, a weight-reducing KD for treatment of obesity and/or type 2 diabetes in adults has not been associated with adverse skeletal effects. By contrast, recent evidence suggests that adaptation to a eucaloric KD may impair bone remodeling in elite adult athletes. Discrepancies in the literature may relate to differences between study populations and in diet formulation.

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“…A recent trend observed by T1DM healthcare professionals, and an area of growing research interest, is the self-selected patient adherence to an LCD or very low-carbohydrate diet ( 4 , 5 , 6 ). Despite this, there is limited literature specifically investigating carbohydrate reduction initiated in T1DM soon after diagnosis with the aim of altering the expected clinical trajectory of the disease process.…”

Section: Introductionmentioning

confidence: 99%

Prolonged remission followed by low insulin requirements in a patient with type 1 diabetes on a very low-carbohydrate diet

Ozoran,

Guwa,

Dyson

et al. 2024

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary The use of a low-carbohydrate diet (LCD) reduces insulin requirements in insulinopenic states such as type 1 diabetes mellitus (T1DM). However, the use of potentially ketogenic diets in this clinical setting is contentious and the mechanisms underlying their impact on glycaemic control are poorly understood. We report a case of a patient with a late-onset classic presentation of T1DM who adopted a very low-carbohydrate diet and completely avoided insulin therapy for 18 months, followed by tight glycaemic control on minimal insulin doses. The observations suggest that adherence to an LCD in T1DM, implemented soon after diagnosis, can facilitate an improved and less variable glycaemic profile in conjunction with temporary remission in some individuals. Importantly, these changes occurred in a manner that did not lead to a significant increase in blood ketone (beta-hydroxybutyrate) concentrations. This case highlights the need for further research in the form of randomised controlled trials to assess the long-term safety and sustainability of carbohydrate-reduced diets in T1DM. Learning points This case highlights the potential of low-carbohydrate diets (LCDs) in type 1 diabetes mellitus (T1DM) to mediate improved diabetes control and possible remission soon after diagnosis. Could carbohydrate-reduced diets implemented early in the course of T1DM delay the decline in endogenous insulin production? Adherence to an LCD in T1DM can facilitate an improved and less variable glycaemic profile. This case suggests that LCDs in T1DM may not be associated with a concerning supraphysiological ketonaemia.

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Low-carbohydrate diets in type 1 diabetes: balancing benefits and risks

Cited by 6 publications

References 45 publications

Diet and Glycemic Index in Children with Type 1 Diabetes

Diet and Glycemic Index in Children with Type 1 Diabetes

Effects of very low carbohydrate ketogenic diets on skeletal health

Prolonged remission followed by low insulin requirements in a patient with type 1 diabetes on a very low-carbohydrate diet

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