Recommendations on the indication of low-carbohydrate diets in people with diabetes mellitus
DOI:
https://doi.org/10.47196/diab.v58i2.802Keywords:
low carbohydrate diet, diabetes, glycemic control, eating plan, glycemic indexAbstract
Reduced carbohydrate diets, especially those low in sucrose and refined starches, with a high glycemic index present in ultra-processed foods and a “cafeteria” diet, have shown improvement in glycemic and metabolic parameters in people with type 1 and type 2 diabetes. In short term studies (6 months), lower postprandial blood glucose levels, lower doses of insulin and oral hypoglycemic agents, lower HbA1c, lower tendency to hyper or hypoglycemia, weight loss, longer time in range and improved sensitivity to insulin were observed. However, this low-CH diet is not recommended for pregnant or breastfeeding women, children, people who have chronic kidney disease, or people with or at risk of eating disorders, and in those who consume iSGLT-2 due to the risk of euglycemic ketoacidosis. The implementation of this eating plan in type 1 diabetes must be advised and supervised by specialists in nutrition and diabetes.
References
I. Osler W, McCrae T. Los principios y la práctica de la medicina. Appleton and Company: Nueva York, NY, EE.UU.; Londres, Reino Unido;1921
II. Joslin Diabetes Center. A history of Elliot P. Joslin. Disponible en: www.joslin.org/about/history.html
III. The DCCT Research Group Diabetes Control and Complications Trial (DCCT): Results of Feasibility Study. The DCCT Research Group. Diabetes Care 1987;10(1):1-19
IV. Foster NC, Beck RW, Miller KM, Clementes MA, Rickels MD, et al. Estate of type 1 diabetes management and outcomes from the T1D exchange in 2016-2018. Diab Tech Therap 2019;21(2):55-73. doi: 10.1089/dia.2018.0384
V. Quarta A, Guarino M, Tripodi R, Giannini C, Chiarelli F, Blasetti A. Diet and glycemic index in children with type 1 diabetes. Nutrients 2023;9:15(16):3507.
VI. Cherubini V, Marino M, Marigliano M, Maffeis C, Zanfardino A, Rabbone I, Giorda S, Schiaffini R, Lorubbio A, Rollato S, Iannilli A, Iafusco D, Scaramuzza AE, Bowers R, Gesuita R. Rethinking carbohydrate intake and time in range in children and adolescents with type 1 diabetes. Nutrients 2021 Oct 29;13(11):3869.
VII. Schmidt S, Christensen MB, Serifovski N, Damm-Frydenberg C, Jensen J-EB, Fløyel T, et al. Low versus high carbohydrate diet in type 1 diabetes: A 12‐week randomized open‐label crossover study. Diabetes Obes Metab 2019;21(7):1680-8
VIII. Kleiner A, Cum B, Pisciotta L, Cincione IR, Cogorno L, Prigione A, et al. Safety and efficacy of eucaloric very low-carb diet (EVLCD) in type 1 diabetes: A one-year real-life retrospective experience. Nutrients 2022;14(15):3208.
IX. Shaker Mahmood B. Impact of low carbohydrate diet on patients with type 1 Diabetes. E3S Web Conf 2023;391:01132. Disponible en: https://www.e3s-conferences.org/articles/e3sconf/pdf/2023/28/e3sconf_icmed-icmpc2023_01132.pdf.
X. Turton JL, Raab R, Rooney KB. Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review. PLoS ONE 2018;13(3):e0194987. doi: 10.1371/journal. pone.0194987.
XI. Dyson P. Low carbohydrate diets and type 2 diabetes. What is the latest evidence? Diabetes Ther 2015 Dec;6(4):411-424.
XII. Brouns F. Overweight and diabetes prevention: is a low-carbohydrate high-fat diet recommendable? Eur J Nutr 2019;58(3):1339.
XIII. Dos Santos Gil M, Cuadra-Espinilla F, Sánchez-Bartrés M. Dieta baja en hidratos de carbono en los pacientes con diabetes tratados con “sistemas de asa cerrada híbrida”. Revista Diabetes 2023. Disponible en: https://www.revistadiabetes.org/wp-content/uploads/Dieta-baja-en-hidratos-de-carbono-en-los-pacientes-con-diabetes-tratados-con-sis.pdf
XIV. Annan SF, Higgins LA, Jelleryd E, Hannon T, Rose S, Salis S, Baptista J, Chinchilla P, Marcovecchio ML. ISPAD Clinical Practice Consensus Guidelines 2022: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2022 Dec;23(8):1297-1321.
XV. Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-carb and ketogenic diets in type 1 and type 2 diabetes. Nutrients 2019 Apr 26;11(5):962.
XVI. Mayer-Davis EJ, Laffel LM, Buse JB. Management of type 1 diabetes with a very low carbohydrate diet: a word of caution. Pediatrics 2018;142(2):e20181536B.
XVII. Smart CE, Annan F, Higgins LA, Jelleryd E, López M, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018;19:136-54.
XVIII. Sai-Krishna G, Tony-David K, Divyanjali P. Ketogenic diet in the management of diabetes. Indo Am J Pharm Resh 2017;7(06):8109- 8115.
XIX. Kripalani Y. Ketogenic diet: a lifestyle modification for type 2 diabetic patients. IJSR 2019;8(5):1798-1800. 19.
XX. Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, Yancy WS Jr, Brinkworth GD. A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. Diabetes Care 2014 Nov;37(11).
XXI. Landry MJ, Crimarco A, Gardner CD. Benefits of low carbohydrate diets: a settled question or still controversial? Curr Obes Rep 2021;10(3):409-422:2909-18.
XXII. Goday A, Bellido D, Sajoux I, Crujeiras AB, Burguera B, García-Luna PP, Oleaga A, Moreno B, Casanueva FF. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr Diabetes 2016;6:e230.
XXIII. Myette-Côté É, Durrer C, Neudorf H, Bammert TD, Botezelli JD, Johnson JD, et al. The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial. Am J Physiol Regul Integr Comp Physiol 2018;315(6):R1210-R1219.
XXIV. Diabetes Canada position statement on low carbohydrate diets for adults with diabetes: a rapid review. Can J Diabetes 2020;44:295-299.
XXV. Management of hyperglycemia in type 2 diabetes 2018. A consensus report by de American Diabetes Association (ADA) and the European Association for the study of Diabetes (EASD). Diabetes Care 2018;41:2669-2701.
XXVI. Position statement low carb diets for people with diabetes. Diabetes UK 2018 Evidence based nutrition guidelines for the prevention and management of diabetes. Disponible en: https://www.diabetes.org.uk/nutrition-guidelines.
XXVII. Seidelman S, Claggett B, Cheng S, et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta análisis. Lancet Public Health 2018;3:e419-28.
XXVIII. World Health Organization. Carbohydrate intake for adults and children WHO guideline 2023. Disponible en: https://www.who.int/publications/i/item/9789240073593.
XXIX. Pérez-Guisado J. Las dietas cetogénicas: potenciales efectos saludables de la Dieta Cetogénica Mediterránea Española. Córdoba: Universidad de Córdoba, Servicio de Publicaciones; 2014.
XXX. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al.; on behalf of the American Diabetes Association. Facilitating positive health behaviors and well-being to improve health outcomes. Standards of Care in Diabetes 2023. Diabetes Care 2023;46(Supp1):S68-S96.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 on behalf of the authors. Reproduction rights: Argentine Society of Diabetes
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.
Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.
