Low-carbohydrate diet in type 1 diabetes: A systematic review

IF 2.6 Q3 NUTRITION & DIETETICS Clinical nutrition ESPEN Pub Date : 2025-06-01 Epub Date: 2025-03-15 DOI:10.1016/j.clnesp.2025.03.009

Sabrina Soares de S. Sousa, Erick Santos Nery, Fernando M.A. Giuffrida

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Abstract

Background

The treatment of type 1 diabetes mellitus (T1D) consists of applying insulins with different action profiles and ingesting known amounts of nutrients from the diet. Although there is no specific recommendation regarding the distribution of these macronutrients, low-carbohydrate (LC) diets seem to show promise in some types of diabetes, but their role in T1D is still controversial, given the potential glycemic improvement, but with the concurrent possibility of changes in other parameters such as lipids. This systematic review aimed to evaluate the metabolic effects of these diets on T1D.

Methods

A systematic review in PubMed, Embase, and Lilacs with publications from the last 10 years was used as a data source.

Results

Nine clinical trials were included. We have found LC diet to be associated with increased time in range in continuous glucose monitoring (+5.68 %, p = 0.01); decreased time below range (−0.53 %, p = 0.01 with 54 mg/dL threshold and −2.28 %; p = 0.01 with 70 mg/dL threshold), coefficient of variation (−5.51 %; p = 0.01), total insulin daily dose (−8.39 %; p = 0.01), and systolic blood pressure (−4.83 mmHg, p = 0.04).

Conclusions

LC diets show potential benefit in metabolic control of people living with T1D, warranting the design of future robust clinical trials.

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低碳水化合物饮食对1型糖尿病的影响：一项系统综述。

背景：1型糖尿病（T1D）的治疗包括使用具有不同作用谱的胰岛素和从饮食中摄取已知量的营养素。虽然没有关于这些常量营养素分布的具体建议，但低碳水化合物（LC）饮食似乎在某些类型的糖尿病中显示出希望，但它们在T1D中的作用仍然存在争议，考虑到潜在的血糖改善，但同时可能改变其他参数，如脂质。本系统综述旨在评估这些饮食对T1D的代谢影响。方法：以PubMed、Embase和Lilacs中近10年的出版物为数据源进行系统评价。结果：纳入9项临床试验。我们发现LC饮食与连续血糖监测的范围时间增加有关（+5.68%,p=0.01）；阈值为-0.53%,p=0.01，阈值为-2.28%；p=0.01，阈值为70 mg/dL)，变异系数(-5.51%；P =0.01)，总胰岛素日剂量(-8.39%；p=0.01)，收缩压（-4.83 mmHg, p=0.04）。结论：LC饮食在T1D患者的代谢控制方面显示出潜在的益处，需要设计未来强有力的临床试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.