While standard of care medical nutrition therapy for type 1 diabetes (T1D) centers on matching carbohydrate to insulin at meals, recent literature has shown superior glycemic control and cardiovascular measures with lower carbohydrate dietary patterns (<130g/day) compared to the standard MyPlate (50% total calories as carbohydrate) approach.
Aims: To determine if a 60-80 g CHO (LC) per day diet leads to improved glycemic control, cardiovascular, and inflammatory markers compared to the standard of care (SOC) (> 150 g CHO per day).
Methods: Participants (age 18-30) with T1D on insulin pump therapy were recruited from an endocrinology practice from May through December, 2018. Glycemic variability (continuous glucose monitor derived time in range (TIR), 70-180 mg/dL and hemoglobin A1c), total cholesterol, HDL, LDL, triglycerides (TRIG), and LDL particle number, and nutrient intake were assessed using a randomized cross over design with 12 week interventions of LC and SOC. An 8-week washout period was employed between interventions.
Preliminary Results: Expressed Mean(SD). 11 subjects started the study and 5 withdrew due to noncompliance. Of the first 4 patients to finish the LC arm, mean TIR increased from 62.2 (16 .2) to 65.7 (16.2) %, + 3.5 (13.4)%; A1c decreased from 7.1 (0.6) to 6.7 (0.6), -0.5% (0.2); Total Cholesterol decreased from 186.3 (7.2) to 172.0 (25.7) mg/dL; LDL decreased from 104.8 (25.7) to 85.0 (9.2) mg/dL; HDL increased from 63.5 (21.9) to 69.8 (25.5) mg/dL; TRIG decreased from 89.5 (14.9) to 75.8 (21.4) mg/dL; LDL Particle number decreased from 1233.7 (286.6) to 1008.3 (61.5) nmol/L. Of the first 3 patients to finish SOC, no significant differences were seen.
Conclusion: These preliminary results are encouraging, demonstrating that LC is associated with trends towards improvements in glycemic control (TIR and A1c) without deleterious effects on lipids. Larger more robust studies are needed for further exploration.
C.M. Crowder: None. D. Jelley: Research Support; Self; AbbVie Inc., AstraZeneca, Novo Nordisk Inc. M. Condren: None. L. Chalmers: None. J.L. Graef: None.
University of Oklahoma Health Sciences Center; Harold Hamm Diabetes Center; OU-TU School of Community Medicine; Dexcom, Inc.