Despite advances in medications and treatment, optimal blood sugar control remains a challenge for most children and adults with Type 1 diabetes. A study in the June 2018 Pediatrics, “Management of Type 1 Diabetes with a Very-Low-Carbohydrate Diet” (online May 7), found that children and adults who used strict dietary measures to help manage blood sugar levels achieved significantly better control than average. Although severe carbohydrate restriction was once the main approach to diabetes management, study authors said, the discovery of insulin led to more balanced diets using medication adjustments to offset carbohydrate intake. But there was no evidence higher carbohydrate diets would lead to better outcomes, they said, and studies show just 20 percent of children and 30 percent of adults with Type 1 diabetes achieve recommended blood sugar levels to minimize the disease’s long-term medical complications. For their study, researchers conducted an online survey of an international social media group for Type 1 diabetes patients following a very-low-carbohydrate diet, averaging 36 grams of carbohydrates a day. Of the 316 respondents, 42 percent were parents of children with Type 1 diabetes. Results showed that participants following a very low carbohydrate diet had average blood sugar levels in an exceptional, near-normal range. They had low rates of adverse events such as hypoglycemia and ketoacidosis, and generally had high levels of satisfaction with health and diabetes control. Study authors cautioned, however, that these findings alone shouldn’t justify a change in diabetes management, calling for additional research to determine the degree of carbohydrate restriction needed to achieve these benefits, optimal insulin regimens to accompany a very low carbohydrate diet, long-term safety, and effects on children’s growth patterns.
Editor’s Note: The solicited commentary, “How Low Can You Go? Does Lower Carb Translate to LowerGlucose?” provides perspective on this study.
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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds