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Short‐term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: A randomized open‐label crossover trial
Author(s) -
Ranjan Ajenthen,
Schmidt Signe,
DammFrydenberg Camilla,
Holst Jens Juul,
Madsbad Sten,
Nørgaard Kirsten
Publication year - 2017
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12953
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , crossover study , endocrinology , insulin , carbohydrate , glucagon , type 1 diabetes , ketone bodies , insulin pump , low carbohydrate , obesity , metabolism , placebo , weight loss , alternative medicine , pathology
The aim of the present study was to assess the effects of a high carbohydrate diet ( HCD ) vs a low carbohydrate diet ( LCD ) on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes. Ten patients (4 women, insulin pump‐treated, median ± standard deviation [s.d.] age 48 ± 10 years, glycated haemoglobin [ HbA1c ] 53 ± 6 mmol/mol [7.0% ± 0.6%]) followed an isocaloric HCD (≥250 g/d) for 1 week and an isocaloric LCD (≤50 g/d) for 1 week in random order. After each week, we downloaded pump and sensor data and collected fasting blood and urine samples. Diet adherence was high (225 ± 30 vs 47 ± 10 g carbohydrates/d; P < .0001). Mean sensor glucose levels were similar in the two diets (7.3 ± 1.1 vs 7.4 ± 0.6 mmol/L; P = .99). The LCD resulted in more time with glucose values in the range of 3.9 to 10.0 mmol/L (83% ± 9% vs 72% ± 11%; P = .02), less time with values ≤3.9 mmol/L (3.3% ± 2.8% vs 8.0% ± 6.3%; P = .03), and less glucose variability (s.d. 1.9 ± 0.4 vs 2.6 ± 0.4 mmol/L; P = .02) than the HCD . Cardiovascular markers were unaffected, while fasting glucagon, ketone and free fatty acid levels were higher at end of the LCD week than the HCD week. In conclusion, the LCD resulted in more time in euglycaemia, less time in hypoglycaemia and less glucose variability than the HCD , without altering mean glucose levels.