Abstract
Aims/hypothesis: The proportion of children with type 1 diabetes (T1D) who have experience with low-carbohydrate diet (LCD) is unknown. Our goal was to map the frequency of LCD among children with T1D and to describe their clinical and laboratory data. Methods: Caregivers of 1040 children with T1D from three centers were addressed with a structured questionnaire regarding the children’s carbohydrate intake and experience with LCD (daily energy intake from carbohydrates below 26% of age-recommended values). The subjects currently on LCD were compared to a group of non-LCD respondents matched to age, T1D duration, sex, type and center of treatment. Results: A total of 624/1040 (60%) of the subjects completed the survey. A total of 242/624 (39%) subjects reported experience with voluntary carbohydrate restriction with 36/624 (5.8%) subjects currently following the LCD. The LCD group had similar HbA1c (45 vs. 49.5, p = 0.11), lower average glycemia (7.0 vs. 7.9, p = 0.02), higher time in range (74 vs. 67%, p = 0.02), lower time in hyperglycemia >10 mmol/L (17 vs. 20%, p = 0.04), tendency to more time in hypoglycemia <3.9 mmol/L(8 vs. 5%, p = 0.05) and lower systolic blood pressure percentile (43 vs. 74, p = 0.03). The groups did not differ in their lipid profile nor in current body height, weight or BMI. The LCD was mostly initiated by the parents or the subjects themselves and only 39% of the families consulted their decision with the diabetologist. Conclusions/interpretation: Low carbohydrate diet is not scarce in children with T1D and is associated with modestly better disease control. At the same time, caution should be applied as it showed a tendency toward more frequent hypoglycemia.
Highlights
Is quite commonplace among children/adolescents with type 1 diabetes (T1D) with 38.7% having the experience with carbohydrate reduction and 5.8% currently keeping the low carbohydrate diet (LCD)
Their main motivation for the initiation of the diet was to improve their glycemic curves and we have shown that children with T1D on the LCD tend to have excellent disease control at the cost of slightly higher time spent in hypoglycemia
The comparison between the LCD subjects and a well-matched control group revealed that the LCD group has excellent disease control with medians for TIR and time in hyperglycemia falling well into the recommended zones
Summary
Most effective strategies include technological solutions [2,3], pharmacotherapy [4] or dietary interventions, including low carbohydrate diet (LCD) [5,6]
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