Impact of low carbohydrate diet on patients with type 1 Diabetes

Abstract

Introduction: Achieving glycemic control in subjects with type 1 diabetes presents a significant challenge to the patient and the healthcare providers. The recommendations for dietary carbohydrates varied over the years from severe restriction to no restriction. We aim to study the impact of low carbohydrate diet on subjects with type 1 diabetes. Subjects and Methods: we conducted a cross over clinical trial in which 46 uncontrolled (HbA1c ≥7%), subjects with type 1 diabetes on a standard carbohydrate diet, were placed on low carbohydrate diet (<26% of daily caloric intake). Patients attending Ain Shams University hospitals outpatient diabetes clinics were invited to participate. Participants were provided with education sessions to achieve and maintain low carbohydrate diet. They visited the clinic at baseline, 3 and 6 months. Results: low carbohydrate diet resulted in significant improvement (p<0.001) in the following parameters using repeated measure analysis of variance: HbA1c (9.2 to 6.6%), weight (82.7kg to 76.7kg), BMI (29.70 to 27.56 Kg/m2), percent body fat (36.7 to 30.2%), skeletal muscle mass (53.8 to 55.9kg), total daily dose of insulin (72 to 54 IU) total cholesterol (199 to 169 mg/dL), LDL (119 to 101mg/dL) triglycerides (182 to 113 mg/dL), ALT (23 to 20IU/L), AST (14 to 12 IU/L), UAC ratio ( 15.7 to 14.0mg/g) and decreased incidence of hypoglycemic and hyperglycemic events (4.4 to 1.1 and 20.8 to 4.0 events/week respectively). Conclusion: low carbohydrate diet demonstrated efficacy in terms of glycemic control and attainment of glycemic targets with good safety profile in terms of lower rates of hypoglycemic events.