Very Low-Carbohydrate Diet Beneficial in Type 1 Diabetes

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Very Low-Carbohydrate Diet Beneficial in Type 1 Diabetes

Following a very low-carbohydrate diet (VLCD) can produce “exceptional” glycemic control for both adults and children with type 1 diabetes, new research finds. 
The results, from more than 300 patients with type 1 diabetes, were published online May 7 in Pediatrics by Belinda S. Lennerz, MD, PhD, of Boston Children’s Hospital and Harvard Medical School, Massachusetts, and colleagues.
Study participants all followed the VLCD regimen described in the book Dr Bernstein’s Diabetes Solution, whose author, Richard K Bernstein, MD, of New York Diabetes Center in Mamaroneck, and who has type 1 diabetes himself, was a study investigator. 
Both the adult and pediatric study participants were able to achieve near-normal HbA1c levels without significant increases in some of the potential adverse effects that have been raised as concerns about such an approach, including hypoglycemia, dyslipidemia, or growth impairment among children. 
“We suggest that a VLCD may allow for exceptional control of type 1 diabetes without increased risk of adverse events. This possibility is mechanistically plausible because of the dominant effects of dietary carbohydrates on postprandial glycemia and the lower insulin doses required with a VLCD,” Lennerz and colleagues write.
However, they caution, “In light of study limitations, these findings by themselves should not be interpreted as sufficient to justify a change in diabetes management.”
In an accompanying editorial, Carly Runge, BS, and Joyce M. Lee, MD, MPH, both of the University of Michigan, Ann Arbor, call the study “an important contribution to the literature,” given the dearth of information about optimal dietary strategies for type 1 diabetes.
Pediatrics. Published online May 7, 2018. Full text, Editorial

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