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  #1   ^
Old Mon, May-07-18, 05:39
JEY100's Avatar
JEY100 JEY100 is offline
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Default Low Carb Diet for Type 1. New study.

As reported in the NYT, a new study using the Type 1 members of the TypeOneGrit FB group, children and adults, who strictly follow Dr. Bernstein's Diet.

https://www.dietdoctor.com/new-stud...ics-on-low-carb

Quote:
A new study by some top researchers shows that type 1 diabetic patients who go on a low-carb high-protein diet achieve great results:

It found that children and adults with Type 1 diabetes who followed a very low-carb, high-protein diet for an average of just over two years — combined with the diabetes drug insulin at smaller doses than typically required on a normal diet — had “exceptional” blood sugar control. They had low rates of major complications, and children who followed it for years did not show any signs of impaired growth.


https://www.nytimes.com/2018/05/07/...l?smid=tw-share


Also in MedPage this morning:

https://www.medpagetoday.com/endocr...1diabetes/72718

Quote:
Carb-Light Diet Helps T1D Patients Achieve Glycemic Control
'Very low-carbohydrate diet' of less than 50 g per day

by Kristen Monaco, Staff Writer, MedPage Today

by Kristen Monaco, Staff Writer, MedPage Today
May 07, 2018

Among people with type 1 diabetes, following a very low-carbohydrate diet (VLCD) can aid in achieving glycemic control, researchers suggested.
Responses from an online survey of people with type 1 diabetes found that those who followed a VLCD reported very good glycemic control -- a mean HbA1c of 5.67% ± 0.66%, according to the study by Belinda Lennerz, MD, PhD, of Boston Children's Hospital, and colleagues. Overall, 97% of these participants achieved the recommended glycemic targets of the American Diabetes Association.

The average blood glucose levels among the subset of patients who reported these values were 104 ± 16 mg/dL, the researchers reported in Pediatrics.
Followers of this diet also noted very few adverse events, with only 2% of the total respondents reporting a diabetes-related hospitalization within the past year -- 1% for ketoacidosis and 1% for hypoglycemia.
Following a switch from a regular diet to the VLCD, participants reported an average change in A1c of -1.45% ± 1.04% (P<0.001). There was also a roughly 0.1% increase in HbA1c for every 10 grams of additional carbohydrates consumed.

"The source and amount of carbohydrates consumed affect postprandial hyperglycemia and glycemic variability more than any other dietary factor, providing a conceptual basis for interest in carbohydrate-modified diets for T1DM," Lennerz et al wrote.

The survey included 316 responses from both adults with type 1 diabetes and the parents of children with type 1 diabetes. These individuals belonged to a Facebook group of people living with type 1 diabetes who adhere to a VLCD. While a VLCD is usually defined as ≤20 to 50 g per day of carbohydrates or ≤5% to 10% of daily caloric intake, the mean carbohydrate intake of these respondents was 36 ± 15 grams per day.

The participants were confirmed as having a positive diabetes antibody test result, a diagnosis of diabetes prior to the age of 20, and a body mass index (BMI) under 30 for adults or lower than the 95% percentile for children. The international cohort included individuals from the U.S., Canada, Europe, and Australia. The findings held similar across pediatric and adults patients.
The pediatric patients' healthcare providers reported that clinical data on the children included in the analysis showed a "marginal decrease" in height following T1D diagnosis: "This possible growth deceleration may have preceded or occurred during the diet and is comparable in magnitude to the previously described decreases in height SDS in T1DM," the researchers suggested, adding that "taken together, these data do not reveal an adverse effect of a VLCD on growth, but additional research into this possibility is warranted."
In an accompanying commentary, Carly Runge and Joyce M. Lee, MD, MPH, both of the University of Michigan in Ann Arbor, praised the study, calling it "an important contribution to the literature." However, they said, a key question that remains is the potential impact the diet may have on pediatric growth, noting that a limitation of the study was the inability to assess pubertal development. Runge and Lee called for a randomized controlled study, to assess not only the effect on HbA1c, but also the frequency of diabetic ketoacidosis, hypoglycemia, BMI, linear growth outcomes, cholesterol, and percentage of time in range.
"Only after the therapy proves efficacious in a trial setting will clinicians have to then tackle the 'barrier' of having patients adhere to this diet."
The study was funded by the National Institutes of Health.

One co-author reported receiving royalties for books on the management of diabetes (which were used by members of the online social media group surveyed for the study). Two other co-authors also reported receiving royalties related to books on low-carbohydrate diets and books on nutrition and obesity in general, and another reported an ownership interest in companies using low-carbohydrate principles. Other co-authors reported financial relationships with Virta Health, Atkins, Merck, and AstraZeneca.

Last edited by JEY100 : Mon, May-07-18 at 09:17.
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  #2   ^
Old Mon, May-07-18, 07:54
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GRB5111 GRB5111 is online now
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This is good news, as Dr. Bernstein has assembled a methodology for Type 1s to use in controlling their condition thus being able to live healthy and meaningful lives. Being able to identify, give credibility, and make available the protocol developed by Dr. Bernstein enables many more to benefit, and has a potential extended influence on those with Type 2 if they are paying attention to the dietary and fitness factors that enable Type 1s to be successful.
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Old Tue, May-08-18, 05:53
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Quote:
the researchers suggested, adding that "taken together, these data do not reveal an adverse effect of a VLCD on growth, but additional research into this possibility is warranted."


Further research into this effect for which there is no evidence is warranted... meanwhile, adverse effect on growth is sort of a loaded term. Those various populations on earth that are more insulin sensitive, more leptin sensitive than us--outside of the Masai, they also seem to be somewhat shorter than us. Not drinking milk or eating twinkies might have made the Hadza or the !Kung or the Kitivans shorter than us, hard to call this adverse over all.
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Old Wed, May-09-18, 02:44
JEY100's Avatar
JEY100 JEY100 is offline
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Dr Ludwig's post about his own study. https://www.drdavidludwig.com/blog/

After recounting all the benefits and positive results, he ends with
Quote:
What’s Next?
Our study has several important limitations. We don’t know the long-term safety and effectiveness of very-low-carbohydrate diets among the broader population with T1DM. Our participants were evidently highly motivated, and may not be representative of all people with T1DM. Other important questions await further study, such as whether less severely restricted diets (ie, allowing more whole fruits, beans and perhaps modest amounts of whole kernel grains) might provide qualitatively similar benefits; how best to dose insulin in conjunction with carbohydrate restriction and physical activity; and how to manage acute illness, when blood sugar and ketone levels rise. Therefore, the results of this study do not by themselves justify a change in diabetes management.

I STRONGLY CAUTION ANYONE WITH DIABETES TO DISCUSS ANY DIETARY CHANGES WITH HIS OR HER DIABETES CARE PROVIDER.

These limitations notwithstanding, our findings raise the possibility that much better diabetes control than currently thought possible might be achievable — with the hope of preventing feared long-term complications. After many decades focused almost entirely on new (and expensive) drugs and technology, it’s time to refocus on the medicinal power of diet.


Not justify a change in diabetes management? Or his group wanting more grant money to research adding beans? Check out RD Dikeman's son, his growth hasn’t suffered from a lack of beans and grains. I hope parents of T1 read the NYT article and do their own research easily available at TypeOneGrit and Dr Bernstein’s YouTube University.
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