The Dietary Science Foundation
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The Dietary Science Foundation has allocated 60,000 EUR to researchers at Karolinska University Hospital for studying how diets with various amounts of carbohydrates affect blood sugar control in type 1 diabetes. One in four people with type 1 diabetes have serious trouble with blood sugar control, so better dietary treatments can save lives.
About 50,000 children and adults in Sweden have type 1 diabetes and the disease is on the rise in many countries. Despite the many sufferers, it’s uncertain what dietary advice is most effective in counteracting the long-term complications, such as kidney, eye and cardiovascular disease. The Swedish National Board of Health and Welfare writes in its current advice on food for diabetes: “The best diet for diabetes is a topic of intense debate. The area is partly unexplored and the scientific evidence is weak.”
“Diabetes doctors like me don’t have sound scientific evidence on which to base good advice. Patients can therefore be given different recommendations depending on which doctor they meet, and that creates confusion. Many people search for information on the internet instead. It shouldn’t be like that,” says Kerstin Brismar, Chair of the Dietary Science Foundation’s scientific advisory board and Professor of diabetes research at Karolinska Institutet.
To fill this gap in knowledge, the Dietary Science Foundation will support a clinical trial led by Anneli Björklund, Associate Professor and Chief Physician, at the Unit for Endocrinology, Metabolism and Diabetes at Karolinska Hospital. She sees a great need for better science in the area:
“It’s important that patients are given dietary advice that will help them feel as healthy as possible. As attending physicians we get a lot of questions about food, but we have no solid scientific evidence to support the advice we give,” she says.
In the study, which will be one of the largest dietary studies ever for people with type 1 diabetes, 150 adults with blood sugar control problems will be randomly allocated into three different groups. One group will be advised to follow a traditional diabetic diet (50-60% carbohydrates), a second group will follow a moderate low-carbohydrate diet (30-40% carbohydrates), and a third group will follow a strict low-carbohydrate diet (10-20% carbohydrates).
During the first few months of the study patients will be given intensive support while following the dietary treatment, and the effects of the change in diet will be studied for one year.
“If the patients lower their blood sugar, their risk of long-term complications will eventually be reduced. We also need to make sure that the dietary treatments don’t cause any dangerous side effects. So among other things we will keep track of how often the patients suffer from hypoglycemia and ketoacidosis. We will also follow their blood lipid levels,” says Anneli Björklund.
There is an ongoing debate about the risks of a low-carbohydrate diet in type 1 diabetes. The one side argues that eating food with a low carbohydrate content increases the risk of both hypoglycemia (too low blood sugar) and ketoacidosis (a life-threatening condition in which the blood becomes acidic). The other side argues that a low-carbohydrate diet leads to more stable blood sugar levels, and therefore a smaller risk for both hypoglycemia and ketoacidosis.
“The debate has been pretty ugly. We think it’s important to do a well-designed scientific study to find out how things stand,” Kerstin Brismar says.
The Dietary Science Foundation is investing at least 60,000 EUR in the study and will collaborate with the researchers at Karolinska Hospital to seek more funding. The study is estimated to cost 360,000 EUR in total.
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