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The New York Times Asked Dr. David Harlan About Eating a Low-Carbohydrate & High Protein Diet with Type 1 Diabetes


How a Low-Carb Diet Might Aid People With Type 1 Diabetes

Dr. David Harlan, co-director of the UMass Diabetes Center of Excellence, was quoted in a May 2018 New York Times Article titled "How a Low-Carb Diet Might Aid People With Type 1 Diabetes."  

The article mentioned that many diabetes experts don't recommend low-carbohydrate with high-protein diets for people with type 1 diabetes, especially children. They're concerned that restricting carbs may lead to dangerously low blood sugar levels, known as hypoglycemia, and could potentially stunt a child’s growth. 

A new study published in Pediatrics, the official journal of the American Academy of Pediatrics suggests otherwise.  It found children and adults with Type 1 diabetes who followed a very low-carb, high-protein diet for an average of just over two years - combined with insulin (at smaller doses than typically required on a normal diet) had “exceptional” blood sugar control.  They experienced low rates of major complications, and children who followed it for years didn't show any signs of impaired growth.

The study saw participants’ average A1c fall to just 5.7%.  An A1c below 5.7% is considered normal, and well below the 6.5% threshold for diabetes. It was an observational study, not a randomized trial with a control group.  

"While it was not a clinical trial, the study is striking because it highlights a community of patients who have been extraordinarily successful at controlling their diabetes with a very low-carb diet," said Dr. Harlan. “Perhaps the surprise is that for this large number of patients it is much safer than many experts would have suggested.”

“I’m excited to see this paper,” Dr. Harlan added. “It should reopen the discussion about whether this is something we should be offering our patients as a therapeutic approach.”

The authors of the published study cautioned it shouldn't lead people to alter diabetes self-management without consulting their care team.  They pointed out that large clinical trials would be necessary to determine if the approach should be used more widely. Standard care for people living with type 1 diabetes is to use a carbohydrate to insulin ratio. New technology such as closed loop combinations of insulin pumps & continuous glucose monitors (CGM) have become game changers.  

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