1186-P: A Short-Term Low Carbohydrate Diet Improves Glycemia in Adolescents and Young Adults with Type 1 Diabetes—Results from a Randomized Crossover Study

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Introduction and Objective: Low carbohydrate diets (LCDs) are used by some living with T1D due to perceived glycemic benefits. Yet, few randomized controlled trials have studied LCDs in youth with T1D.Methods: Youth (12-25y) with T1D enrolled in a randomized crossover study to follow a LCD (<15% calories from carbs) and a standard carbohydrate diet (SCD, ≥40% calories from carbs) for ~2 weeks. A registered dietician designed the LCD; food was prepared by a metabolic kitchen. Adherence, measured by 24-h dietary recalls, occurred 3 days/week, including 1 weekend day.Results: Nineteen youth (mean ± SD 17±2.8y, 7F, 11 NHW, A1c 7.6%±1.1%, 17 using automated insulin delivery) were randomized and included in the analysis, with 95% completing both diets. The LCD was associated with a 57% reduction in carbs and increased time in range (9.3%, 95% CI 4.5-14%, p=0.002) compared to SCD (Table). The LCD was associated with a lower 24-h mean sensor glucose, lower glycemic variability, and less hyperglycemia, without increased hypoglycemia. Total daily insulin was 33% lower with a LCD. Most participants (14/15) who completed interviews said they would choose to follow a LCD in the future.Conclusion: A LCD is a potential treatment option to increase time in range without increasing hypoglycemia in youth with T1D. Future research is needed to determine if LCDs are safe and sustainable among a broader population in a real-world setting.

Disclosure

L.M. Nally: Consultant; Medscape, Medtronic. J. Lukasik: None. R.I. Herzog: None. B. Mittendorfer: Consultant; Nestlé Health Science. A.M. Goss: None. M. Savoye: None. P. Rose: Other Relationship; Tandem Diabetes Care, Inc. S. McCollum: None. V. Shabanova: None. J.L. Sherr: Consultant; Abbott. Advisory Panel; StartUp Health T1D Moonshot. Research Support; Dexcom, Inc. Advisory Panel; Cecelia Health, MannKind Corporation. Consultant; Insulet Corporation, Vertex Pharmaceuticals Incorporated, Ypsomed AG. Advisory Panel; Medtronic, Vertex Pharmaceuticals Incorporated.

Funding

NIH (K23DK128560, 5P30DK045735)



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