Plain language summary
With the advent of self-managed insulin by injection, Type 1 diabetics were able to eat a normal diet and not worry about their carbohydrate intake. However this regime requires careful carbohydrate counting and insulin dosing, which is not always easy to do. With interest in low carbohydrate diets in the management of Type 2 diabetes increasing, some Type 1 diabetics are restricting their carbohydrates in order to better control their blood glucose levels. This pilot study was a small, single-blinded randomised control trial of 10 individuals. It aimed to determine the effects of low carbohydrate diets on glycaemic control, daily insulin requirements and quality of life in Type 1 Diabetes, when compared to those on a normal diet. The results showed that HbA1C reduced significantly in the carbohydrate restricted group compared to the group eating a normal diet. The amount of injected insulin also showed a significant reduction in the low-carbohydrate group. There were no changes in blood pressure, creatinine or lipid profile in either of the groups. A low-carbohydrate diet is a feasible option for clients with Type 1 Diabetes who are looking for improved glycaemic control and reduced doses of insulin, particularly if they would like to lose weight.
Abstract
BACKGROUND AND OBJECTIVES To determine the effect of a low carbohydrate diet and standard carbohydrate counting on glycaemic control, glucose excursions and daily insulin use compared with standard carbohydrate counting in participants with type 1 diabetes. METHODS AND STUDY DESIGN Participants (n=10) with type 1 diabetes using a basal; bolus insulin regimen, who attended a secondary care clinic, were randomly allocated (1:1) to either a standard carbohydrate counting course or the same course with added information on following a carbohydrate restricted diet (75 g per day). Participants attended visits at baseline and 12 weeks for measurements of weight, height, blood pressure, HbA1c, lipid profile and creatinine. They also completed a 3-day food diary and had 3 days of continuous subcutaneous glucose monitoring. RESULTS The carbohydrate restricted group had significant reductions in HbA1c (63 to 55 mmol/mol (8.9-8.2%), p<0.05) and daily insulin use (64.4 to 44.2 units/day, p<0.05) and non-significant reductions in body weight (83.2 to 78.0 kg). There were no changes in blood pressure, creatinine or lipid profile and all outcomes in the carbohydrate counting group were unchanged. There was no change in glycaemic variability as measured by the mean amplitude of glycaemic excursion in either group. CONCLUSIONS A low carbohydrate diet is a feasible option for people with type 1 diabetes, and may be of benefit in reducing insulin doses and improving glycaemic control, particularly for those wishing to lose weight. 背景与目的：在1 型糖尿病患者中，与标准碳水化合物计数比较，确定低碳水 化合物饮食对血糖控制、血糖波动以及每日胰岛素使用的影响。方法与研究 设计：参加二级保健门诊使用普通膳食以注射胰岛素为治疗方案的10 例1 型 糖尿病患者，按照1:1 的比例随机分配到一个标准的碳水化合物计数组，或限 制碳水化合物饮食组（每天75 g）。测量了所有志愿者基线和12 周的体重、 身高、血压、糖化血红蛋白、血脂和肌酐，志愿者完成了为期3 天的食物日记 和3 天持续皮下血糖监测。结果：碳水化合物限制组HbA1c（63-55 mmol/mol （8.9-8.2 %），p<0.05）和每日胰岛素用量（64.4-44.2 U/d，p<0.05）显著减 少，体重（83.2-78 kg）的变化无显著差异。碳水化合物计数组血压、肌酐或 血脂所有指标均无显著改变。通过平均血糖波动幅度计算的血糖变异性在任何 一组中均无改变。结论：低碳水化合物饮食是1 型糖尿病患者一个可行的选 择，可以减少胰岛素剂量和改善血糖控制，特别是对那些希望减肥的患者。.
Methodological quality
Allocation concealment
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No
