Safety and Feasibility of a Low Carbohydrate Diet in Children With Type 1 Diabetes

The Washington University

Status

Completed

Conditions

Type 1 Diabetes

Treatments

Other: Low carbohydrate diet

Study type

Interventional

Funder types

Other

Identifiers

NCT04228822

201911121

Details and patient eligibility

About

Good glycemic control in individuals with Type 1 diabetes (T1D), has been proven to reduce the risk of diabetes-related complications. Despite technological advances such as the use of insulin delivery devices and continuous glucose monitoring, the average glycemic control in T1D is poor. Though dietary management plays a major role in the overall management of T1D, and it is often classified as the most challenging aspect of treatment, the 2019 Standards of Medical Care in Diabetes for children and adolescents do not clearly address dietary management. As carbohydrate is the macronutrient with the greatest impact on blood glucose, it is reasonable to suggest that carbohydrate reduction will minimize postprandial glucose excursions and improve diabetes control. For this reason, low carbohydrate diets (LCD) have gained popularity, and observational studies report positive glycemic outcomes. However, to date, scientific evidence from randomized trials on the impact of LCD in children with T1D is lacking. Thus, the over-arching goal of this pilot study is to evaluate the feasibility and safety of a low carbohydrate diet in children with T1D, and as an exploratory aim, we will evaluate the efficacy of LCD on glycemic control.

Full description

The investigators aim to study 40 subjects ages 5-11 with T1D to evaluate the feasibility of LCD. Participants will be asked to attend a total of 5 visits (4 in person and 1 phone visit) during the 6 month-duration of the study. Participants will be randomized to an intervention group with a LCD (50% of carbohydrate recommended daily allowance) vs. the standard diet.

During the screening visit, participants will be assessed by a dietitian to categorize their existing dietary regimen before randomization to either the LCD or the standard diet. In addition, participant's insulin regimen (either pump settings or multiple dose insulin injection therapy) will be reviewed for insulin dose adjustments as needed over a 2 week-period.

Enrollment

8 patients

Sex

All

Ages

5 to 11 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients 5-11 years of age, with history of Type 1 diabetes for longer than 2 years,
No carbohydrate restrictions at the time of recruitment.
No medications that could affect appetite
Regular attendance at the clinic (3-4 times per year),
Glycated hemoglobin (HbA1c) <10%.

Exclusion criteria