Introducing a very low carbohydrate diet for a child with type 1 diabetes

2019 ◽  
Vol 28 (15) ◽  
pp. 1015-1019
Author(s):  
Caroline de Souza Bosco Paiva ◽  
Maria Helena Melo Lima
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycated Haemoglobin ◽  
Healthy Weight ◽  
Carbohydrate Diet ◽  
Glucose Levels ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
Continuous Glucose Monitors

Type 1 diabetes mellitus is a serious autoimmune disease for which no cure is available. The treatment includes insulin therapy, carbohydrate counting, eating healthy foods, exercising regularly, and maintaining a healthy weight. The goal is to keep blood glucose levels close to normal most of the time to delay or prevent complications. Despite the increase in the use of insulin pumps and continuous glucose monitors in recent years, the management of type 1 diabetes remains suboptimal in terms of glycaemic control and normal glycated haemoglobin (HbA1c) level. This article discusses the case of a child with type 1 diabetes who was successfully treated with a very low-carbohydrate diet, resulting in normal levels of HbA1c and normal blood glucose 95% of the time in a range of 70–180 mg/dL (4.0 mmol/L−10 mmol/L). Therefore, further studies are needed to verify how a very low carbohydrate diet impacts child development.

scholarly journals Effects of a low-carbohydrate diet in adults with type 1 diabetes: an interventional study protocol

2021 ◽  
Vol 8 (3) ◽  
pp. 233
Author(s):  
Jessica L. Turton ◽  
Grant D. Brinkworth ◽  
Helen M. Parker ◽  
Kevin Lee ◽  
David Lim ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Dietary Factors ◽  
Interventional Study ◽  
Glucose Levels ◽  
Low Carbohydrate Diet ◽  
Blood Glucose Levels ◽  
Low Carbohydrate

<p><strong>Background:</strong> Type 1 diabetes (T1D) is an autoimmune condition characterised by pancreatic beta cell destruction and absolute insulin deficiency. The varying impact of dietary factors on blood glucose levels is well-known, yet there remains a lack of consensus surrounding the optimal dietary approaches to achieve glycaemic control in T1D. The aim of this research is to assess the efficacy of a low-carbohydrate (LC) diet in adults with T1D. We will set out to determine whether significant differences in T1D management outcomes exist between a LC diet and habitual diets higher in carbohydrate. Our primary hypothesis is that a LC diet will result in improved T1D management compared to habitual diets higher in carbohydrates. <strong></strong></p><p><strong>Methods:</strong> This is a 28-week single arm within-participant intervention study involving a 4-week control period, a 12-week intervention period and a 12-week follow-up. We plan to recruit 20 adults (18-60 years) with T1D (duration ≥6 months) who have suboptimal glycaemic control (HbA1c&gt;7.0%). The primary outcome is haemoglobin A1c (HbA1c) and secondary outcomes include glycaemic variability, frequency of hypoglycaemia, total daily insulin, and quality of life. This LC diet will start at 50 g of digestible carbohydrate per day and then there will be opportunity to increase or decrease within a broader range of 25-75 g/day according to individual blood glucose levels and personal preference.  Participants will meet individually with the study dietitian for a total of six fortnightly sessions to receive dietary instruction, strategies, and education. Participants will continue to work with a member of their usual diabetes care team for specific advice regarding insulin management.</p><p><strong>Conclusions:</strong><em> </em>Current dietary management strategies for T1D appear to be lacking in effect and additional dietary therapies, including LC diets, require urgent consideration. Therefore, an interventional study investigating a patient-led LC dietary approach will be of important clinical relevance for healthcare practitioners and may help to better inform clinical practice guidelines for T1D management.</p><p><strong>Trial Registration<em>: </em></strong>https://www.anzctr.org.au/ACTRN12621000764831.aspx <em></em></p>

scholarly journals Low carbohydrate diet and improved glycaemic control in a patient with type one diabetes

2018 ◽  
Vol 2018 ◽  
Author(s):  
Mirjam Eiswirth ◽  
Ewan Clark ◽  
Michael Diamond
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Variability ◽  
List Type ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate ◽  
Type One Diabetes ◽  
Clinical Benefits

Summary We present the case of an adult female with type 1 diabetes, whose HbA1c was trending at 58 mmol/mol (7.5%) for the past 3 years. In August 2016, she reduced her total daily carbohydrate intake to 30–50 g and adjusted her other macronutrients to compensate for the calorific deficit. Her HbA1c fell to 34 mmol/mol (5.3%) by January 2017 and average daily blood glucose readings decreased significantly from 10.4 to 6.1 mmol/L. Moreover, she observed a marked reduction of average daily glucose variability. Notably, there were no significant episodes of hypo- or hyperglycaemia and her lipid profile remained static. Subjectively, she described an improvement in her quality of life and the dietary transition was extremely well tolerated. We discuss these findings in detail and the potential clinical benefits for patients with type 1 diabetes that can be gained by following a low carbohydrate diet. Learning points: A low carbohydrate diet was found to substantially reduce HbA1c values and blood glucose (BG) variability, as well as causing a significant reduction in average daily glucose values in a patient with T1DM. Although further research is warranted, low carbohydrate diets in patients with T1DM have the potential to positively impact long-term morbidity and mortality through reduction of BG variability and average daily BG values. The diet was well tolerated and not associated with any adverse effects within this study.

scholarly journals Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet: A Word of Caution

PEDIATRICS ◽  
2018 ◽  
Vol 142 (2) ◽  
pp. e20181536B ◽  
Author(s):  
Elizabeth J. Mayer-Davis ◽  
Lori M. Laffel ◽  
John B. Buse
Keyword(s):  
Type 1 Diabetes ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate

scholarly journals Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet

PEDIATRICS ◽  
2018 ◽  
Vol 141 (6) ◽  
pp. e20173349 ◽  
Author(s):  
Belinda S. Lennerz ◽  
Anna Barton ◽  
Richard K. Bernstein ◽  
R. David Dikeman ◽  
Carrie Diulus ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
Low Carbohydrate

scholarly journals Changes in the lipidome in type 1 diabetes following low carbohydrate diet: a randomized crossover trial

2020 ◽  
Author(s):  
Naba Al-Sari ◽  
Signe Schmidt ◽  
Tommi Suvitaival ◽  
Min Kim ◽  
Kajetan Trost ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Hdl Cholesterol ◽  
High Carbohydrate Diet ◽  
Carbohydrate Diet ◽  
Low Carbohydrate Diet ◽  
High Carbohydrate ◽  
Lipid Species ◽  
Low Carbohydrate ◽  
Before And After

Aims/hypothesis: Lipid metabolism might be compromised in type 1 diabetes and the understanding of their physiology is critically important. This study aimed to compare the change in plasma lipid concentrations during carbohydrate dietary changes in individuals with type 1 diabetes and identify predictive biomarkers and early-stage pathophysiology for dyslipidaemia. We hypothesized that: (1) the lipidomics profiles before and after ingesting low or high carbohydrate diet for 12 weeks would be different; and (2) specific annotated lipid species would have significant associations with metabolic outcomes. Methods: Ten adults with type 1 diabetes (mean+/-SD: age 43.6+/-13.8 years, diabetes duration 24.5+/-13.4 years, BMI 24.9+/-2.1 kg/m2, HbA1c 57.67+/-2.6 mmol/mol) using insulin pumps participated in a randomized 2-period crossover study with a 12-week intervention period of low carbohydrate diet (< 100 g carbohydrates/day) or high carbohydrate diet (> 250 g carbohydrates/day) respectively, separated by a 12-week washout period. A large-scale non-targeted lipidomics was performed with mass spectrometry for fasting plasma samples obtained before and after each diet intervention. Logitudinal lipid levels were analysed using linear mixed-effects models. Results: In total, 289 lipid species were identified from 14 major lipid classes (triacylglycerides, phosphatidylcholines, phosphatidylethanolamines, hexosyl-ceramide, sphingomyelins, lyso-phosphatidylcholines, ceramides, lactosyl-ceramide, lyso-phoshatidylethanolamine, free fatty acids, phosphatidylinositols, phosphatidylglycerols, phosphatidylserines and sulfatides). Comparing the two diets, 11 lipid species belonging to sphingomyelins, phosphatidylcholines and LPC(O-16:0) were changed. All the 11 lipid species were significantly elevated during low carbohydrate diet. Two lipid species were most differentiated between diets, namely SM(d36:1) (B+/-SE: 1.44+/-0.28, FDR = 0.010) and PC(P-36:4)/PC(O-36:5) (B+/-SE: 1.34+/-0.25, FDR = 0.009) species. Poly-unsaturated PC(35:4) was inversely associated with BMI and positively associated with HDL-cholesterol (p < 0.001). Conclusion/interpretation: Lipidome-wide outcome analysis of a randomized cross-over trial of individuals with type 1 diabetes following a low carbohydrate diet showed an increase in sphingomyelins and phosphatidylcholines which are thought to reduce dyslipidaemia. The poly-unsaturated phosphatidylcholine 35:4 was inversely associated with BMI and positively associated with HDL-cholesterol (p < 0.001). Results from this study warrant for more investigation on the long-term effect of PC(35:4) lipid-species in lipid homeostasis in type 1 diabetes. Trial registration Clinicaltrials.gov NCT02888691 Keywords Biomarker ∙ Cardiovascular disease ∙ Dyslipidaemia ∙ Lipidomics ∙ Low carbohydrate diet ∙ Randomized trial ∙ Type 1 diabetes.

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