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Preliminary Data: A low-carbohydrate diet has a positive effect on blood sugar in type 1 diabetes
20/09/2024
Reducing carbohydrates leads to more stable and lower blood sugar levels in type 1 diabetes, while insulin needs decrease. This is what the preliminary results from the largest study ever conducted on diet in type 1 diabetes show, a study to which the Dietary Science Foundation has contributed.
There is currently no scientific basis for providing dietary advice for type 1 diabetes, an autoimmune form of diabetes that affects over 50,000 people in Sweden. To address this, in 2017 the Dietary Science Foundation funded an evaluation of how different carbohydrate intakes affect blood sugar levels in type 1 diabetes. Recently Afroditi Barouti, PhD in Medicine and dietitian at the Center for Diabetes in the Stockholm Region, presented the first preliminary results from the study at the European Association for the Study of Diabetes (EASD) conference in Madrid.
A low-carbohydrate diet reduces blood sugar spikes in type 1 diabetes
In the study, researchers randomly assigned 103 adults with type 1 diabetes to one of three dietary plans: a traditional diabetes diet with 50–60% carbohydrates, a moderate low-carbohydrate diet with 30–40% carbohydrates, and a stricter low-carbohydrate diet with 15–20% carbohydrates. The results that Afroditi Barouti presented are from the three month follow-up (the dietary intervention lasted six months and was followed by a six-month observation period).
“The participants wore continuous glucose monitors, and we saw a significant difference between the groups. In the low-carbohydrate group, time spent within the recommended blood sugar target range increased by 12% compared to those on a traditional diabetes diet,” says Afroditi Barouti.
Above all, the low-carbohydrate diet led to fewer high blood sugar spikes, which is an important improvement. Data from the Swedish Diabetes Registry show that 65% of all adults with type 1 diabetes have blood sugar levels above the target range, increasing their risk of cardiovascular disease and other severe diabetes complications.
A low-carbohydrate diet appears to reduce anxiety and stress in type 1 diabetes
Along with stabilizing blood sugar levels, the low-carbohydrate diet reduced participants’ insulin needs. Some participants also reported decreased stress related to the disease.
“Stable blood sugar levels are crucial for patients. Many experience stress and anxiety when their blood sugar levels are low, and they don’t feel good when their levels are high either,” Afroditi Barouti says.
Currently, a low-carbohydrate diet is not recommended for people with type 1 diabetes as physicians fear it may negatively affect blood lipids. But the researchers found no evidence of such effects:
“We found no statistical difference in blood lipids after three months.”
No signs of increased risk for dangerous side effects
Another concern has been that a low-carbohydrate diet might increase the risk of a dangerous condition called ketoacidosis, but this was not confirmed by the researchers.
“These are preliminary data, so we shouldn’t make definitive statements yet, but it seems that the benefits of a low-carbohydrate diet outweigh the risks. However, I want to emphasize that the diet we studied was not ketogenic,” says Anneli Björklund, associate professor, senior physician, and project leader for the study.
The same conclusion—that a low-carbohydrate diet has positive effects in type 1 diabetes—has also been reached by researchers at the University of Gothenburg. Last December, they published a study in which people with type 1 diabetes followed a moderate low-carbohydrate diet for four weeks. The results showed that a diet with a reduced amount of carbohydrates leads to lower and more stable blood sugar levels without any negative health effects.
Challenges in adhering to both high-carb and low-carb diets
One experience from the study at the Center for Diabetes was that participants generally found it difficult to adhere to both the traditional high-carbohydrate diet and the stricter variation of the low-carbohydrate diet. The high-carbohydrate diet led to significant blood sugar fluctuations, while the stricter low-carbohydrate diet required a lot of planning. Participants found it easiest to follow a moderate low-carbohydrate diet.
“Our goal is not to restrict anyone to a specific diet but to explore more dietary strategies so that there are several options available. Many people with type 1 diabetes want better support for their dietary strategy, but because of a lack of evidence for low-carbohydrate diets in type 1 diabetes, they can encounter resistance in healthcare. There’s been a gap between patients and caregivers, which is why it’s important to research this,” says Afroditi Barouti.
After the EASD conference, she and Anneli Björklund will conduct a more thorough analysis of all the study data. The goal is to publish the results in a scientific journal by 2025.
Thanks to everyone who contributed to the study
The Dietary Science Foundation is incredibly grateful to have contributed to this important research. It would not have been possible without your support. A big thank you to you everyone! The study will provide a stronger foundation for giving dietary advice to people with type 1 diabetes. This could be life-changing for those with the condition, not just in Sweden but worldwide.
