title: Short-term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: A randomized open-label crossover trial.
abstract: The aim of the present study was to assess the effects of a high carbohydrate diet (HCD) vs a low carbohydrate diet (LCD) on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes. Ten patients (4 women, insulin pump-treated, median ± standard deviation [s.d.] age 48 ± 10 years, glycated haemoglobin [HbA1c] 53 ± 6 mmol/mol [7.0% ± 0.6%]) followed an isocaloric HCD (≥250 g/d) for 1 week and an isocaloric LCD (≤50 g/d) for 1 week in random order. After each week, we downloaded pump and sensor data and collected fasting blood and urine samples. Diet adherence was high (225 ± 30 vs 47 ± 10 g carbohydrates/d; P < .0001). Mean sensor glucose levels were similar in the two diets (7.3 ± 1.1 vs 7.4 ± 0.6 mmol/L; P = .99). The LCD resulted in more time with glucose values in the range of 3.9 to 10.0 mmol/L (83% ± 9% vs 72% ± 11%; P = .02), less time with values ≤3.9 mmol/L (3.3% ± 2.8% vs 8.0% ± 6.3%; P = .03), and less glucose variability (s.d. 1.9 ± 0.4 vs 2.6 ± 0.4 mmol/L; P = .02) than the HCD. Cardiovascular markers were unaffected, while fasting glucagon, ketone and free fatty acid levels were higher at end of the LCD week than the HCD week. In conclusion, the LCD resulted in more time in euglycaemia, less time in hypoglycaemia and less glucose variability than the HCD, without altering mean glucose levels.
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Danish Diabetes Academy, Odense, Denmark.
authors.forename: Ajenthen
authors.identifier: 0000-0002-2253-6071
authors.initials: A
authors.lastname: Ranjan
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|Danish Diabetes Academy, Odense, Denmark.
authors.forename: Signe
authors.initials: S
authors.lastname: Schmidt
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Camilla
authors.initials: C
authors.lastname: Damm-Frydenberg
authors.affiliation: NFF Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.|NFF Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
authors.affiliation: Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Nørgaard
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology*; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D003925:Diabetic Angiopathies / Q000097:blood / Q000178:diet therapy; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose
keywords: continuous glucose monitoring; continuous subcutaneous insulin infusion; dietary intervention; dyslipidaemia; glycaemic control; hypoglycaemia