The Grapevine

Type 1 Diabetes: Low Carbohydrate Diet May Help Control Blood Sugar Level

There is no known cure for type 1 diabetes, a condition which is managed by administering insulin with an injection or insulin pump. But encouraging findings from a new study showed that a diet low in carbohydrates was an effective tool to control blood sugar levels in a group of patients.

The paper titled "Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet" was published in the journal Pediatrics on May 7.

Researchers from Boston Children's Hospital in Massachusetts recruited 316 members from a Facebook community called TypeOneGrit, a group for those with type 1 diabetes. 42 percent of the participants were children. The participants followed a very-low-carb diet as recommended in the book Dr. Bernstein's Diabetes Solution by Dr. Richard Bernstein, one of the co-authors of the new study.

Dr. Bernstein developed type 1 diabetes at the age of 12 and is considered a pioneer for his well-known advocacy of the low-carbohydrate dietary approach.

Participants reported an average daily carbohydrate intake of 36 grams, which made up 5 percent of total calories. Usual recommendations state that carbohydrates should make up 45 percent of total calories, which includes 45 to 60 grams per meal and 10 to 25 grams per snack, arriving at a total of 135 to 230 grams per day.

The participants also took smaller doses of insulin than what is usually recommended for patients on normal diets.

Despite this, the researchers found that the patients had exhibited "exceptional control" over their blood sugar levels with no increased risk of adverse events. A1C levels fell from 7.15 percent (within the diabetic range) to 5.67 percent (within the normal range), while children did not experience stunted growth or other such complications.

"Their blood sugar control seemed almost too good to be true," said lead author Belinda Lennerz, a pediatric endocrinology instructor at Harvard Medical School. "It’s nothing we typically see in the clinic for Type 1 diabetes."

While it can be hard to maintain, a low-carbohydrate diet can offer a number of benefits such as blood glucose control, low-calorie intake, increased vegetable intake, and a reduced risk of high blood pressure, metabolic syndrome, and cardiovascular disease.

However, this dietary approach has been subject to debate. Some experts have raised doubts about very-low-carb diets possibly increasing the risk of hypoglycemia or low blood sugar. Another concern is that the diet may be detrimental by stunting growth in children. But the results of the new study have opened up further discussions on whether the diet can be offered as a management tool to patients. 

"We think the findings point the way to a potentially exciting new treatment option," said co-author Dr. David Ludwig, a pediatric endocrinologist at Boston Children’s Hospital.

Because the study was an observational one, the authors cautioned that more research is needed to confirm these findings in the form of controlled clinical trials.