Very Low-Carb Diets Linked to Better Blood Sugar in Children With Type 1 Diabetes

An analysis of registry data of 45,569 children with Type 1 diabetes found that very low-carbohydrate diets were associated with better blood sugar control and lower insulin doses, without evidence of severe hypoglycemia or diabetic ketoacidosis, according to research presented at the European Association for the Study of Diabetes annual meeting in Milan, Italy ^[1]. The study, conducted by researchers from Germany and the United States, analyzed 25 years of data on children ages 1 to 17.

The findings, which are observational and have not been peer-reviewed, suggest that a diet deriving less than 10% of daily calories from carbohydrates may offer metabolic benefits for young people with Type 1 diabetes.

The analysis categorized children by carbohydrate intake: very low (less than 10% estimated daily calories), low (10 to less than 26%), and standard (26% or more). The very low-carb group comprised 219 children, the low-carb group 4,837 children, and the standard-carb group 40,513 children.

Study Methodology and Cohort

The study drew on data from a German diabetes registry, tracking children over a quarter-century. Researchers adjusted for sex, age, migration background, and diabetes duration to isolate the association between carbohydrate intake and health outcomes.

The cohort sizes varied widely, with the very low-carb group representing a small fraction of the total population. The 219 children on very low-carb diets were compared against 4,837 on low-carb diets and 40,513 on standard diets. The disparity in group sizes reflects the relative rarity of very low-carbohydrate eating patterns among children with Type 1 diabetes in the registry.

The follow-up periods also differed, with children on standard diets tracked for an average of 3.67 years, compared with 2.4 years for the low-carb group and 2.18 years for the very low-carb group.

Key Findings on Blood Sugar and Insulin

Children in the very low- and low-carbohydrate groups showed smaller increases in body mass index compared with those in the standard-carbohydrate group over the follow-up period.

Participants on very low-carb diets required lower basal insulin doses and scored lower on a combined measure of blood sugar plus insulin needs.

The absence of these acute complications is notable because very low-carbohydrate diets can increase the risk of ketoacidosis in people with Type 1 diabetes if insulin is insufficient. The researchers reported that the very low-carb group did not show a higher incidence of these events, though the observational nature of the data limits definitive conclusions about safety.

The findings on body mass index contrast with some previous research. The new study did not report such associations, but the authors emphasized that the results require confirmation in controlled trials.

Safety, Growth, and Expert Perspectives

Lead researcher Christian Denzer said the diet showed metabolic benefits without affecting growth or increasing the risk of nutritional deficiencies, high cholesterol, or low blood sugar.

Dr. Victoria Finn, a board-certified endocrinologist not involved in the study, said cutting carbohydrates leads to significant insulin dose reduction.

Finn emphasized the need for frequent monitoring of growth, weight, blood fats, and nutrition under close supervision. She noted that the study’s limitations include self-reported diet data and the inability to monitor actual eating patterns.

The study’s observational design means it cannot establish causation.

Conclusion: Historical Context and Caveats

Carbohydrate restriction has been used to treat diabetes since the 1700s, but it fell out of favor after insulin became available in the 1920s.

Low-carbohydrate diets regained popularity in recent decades, particularly for Type 2 diabetes. The new study extends this line of inquiry to children with Type 1 diabetes.

However, the researchers could not rule out that other factors, including self-reported diet data, affected the findings. The study’s observational nature and the small size of the very low-carb group (219 children) mean the results should be interpreted with caution.

Reference:

1. Very Low-Carb Diet Linked to Health Benefits in Children With Type 1 Diabetes. https://www.theepochtimes.com/health/very-low-carb-diet-linked-to-health-benefits-in-children-with-type-1-diabetes-6100709