Beneficial effects of low carbohydrate diet and sports in patients with type 1 diabetes

Authors

  • Zalán Zelena Pediatrics Clinic no. I. of Semmelweis University
  • Dóra Zelena University of Pécs https://orcid.org/0000-0001-5616-1100
  • Anna Körner Pediatrics Clinic no. I. of Semmelweis University

DOI:

https://doi.org/10.33910/2687-1270-2023-4-1-58-68

Keywords:

diabetes, T1DM, low carb diet, physical activity, blood glucose level

Abstract

To reduce obesity and cardiovascular risk, a combination of low carbohydrate diet and sport is a good choice in otherwise healthy individuals. However, among patients with type 1 diabetes mellitus (T1DM), consuming a minimum of 130 g carbohydrates per day is recommended, and the desire to exercise decreased as well. We wanted to demonstrate that a low carbohydrate diet during physical activity in T1DM patients is safe with the right choice of insulin dosing and reduces the development of both short- and long-term complications. To this end, we collected data from T1DM patients on a normal and low carbohydrate diet using a questionnaire as well as measured blood glucose levels while exercising in healthy and T1DM patients. The main benefit of the diet was that it provided a safe exercise option with more stable blood glucose levels and lower bolus insulin requirements. Our data support that the emergence of new types of insulins, tissue glucose sensors, and pumps has provided the conditions for a freer, less complicated life for patients with T1DM, for which the combined use of a normal and low carbohydrate diet can be an important tool.

References

Abe, Y., Kikuchi, T., Nagasaki, K. et al. (2009) Usefulness of GPT for diagnosis of metabolic syndrome in obese Japanese children. Journal of Atherosclerosis and Thrombosis, vol. 16, no. 6, pp. 902–909. https://doi.org/10.5551/jat.1933 (In English)

Basu, R., Johnson, M. L., Kudva, Y. C. et al. (2014) Exercise, hypoglycemia, and type 1 diabetes. Diabetes Technology & Therapeutics, vol. 16, no. 6, pp. 331–337. https://doi.org/10.1089/dia.2014.0097 (In English)

Boér, K. (2021) Az étrend és a fizikai aktivitás hatása a daganatos betegségek kockázatára [The effect of diet and physical activity on the risk of cancer]. Orvostovábbképző szemle. [Online]. Available at: http://otszonline.hu/onkologia_osszefoglalo_kozlemeny/cikk/az_etrend_es_a_fizikai_aktivitas_hatasa_a_daganatos_betegsegek_kockazatara (accessed 28.04.2021). (In Hungarian)

Burr, J. F., Shephard, R. J., Riddell, M. C. (2012) Physical activity in type 1 diabetes mellitus: Assessing risks for physical activity clearance and prescription. Canadian Family Physician, vol. 58, no. 5, pp. 533–535. https://pubmed.ncbi.nlm.nih.gov/22586195 (In English)

Ceriello, A., Esposito, K., Piconi, L. et al. (2008) Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes, vol. 57, no. 5, pp. 1349–1354. https://doi.org/10.2337/db08-0063 (In English)

Chen, Q., Lu, M., Monks, B. R., Birnbaum, M. J. (2016) Insulin is required to maintain albumin expression by Inhibiting Forkhead Box O1 protein. Journal of Biological Chemistry, vol. 291, no. 5, pp. 2371–2378. https://doi.org/10.1074/jbc.M115.677351 (In English)

Colberg, S. R., Laan, R., Dassau, E., Kerr, D. (2015) Physical activity and type 1 diabetes: Time for a rewire? Journal of Diabetes Science and Technology, vol. 9, no. 3, pp. 609–618. https://doi.org/10.1177/1932296814566231 (In English)

Inchauspé, J. (2023) Glucose goddess method: The 4-week guide to cutting cravings, getting your energy back, and feeling amazing. New York: Simon & Schuster Publ., 272 p. (In English)

Kjaer, I. G., Kolle, E., Hansen, B. H. et al. (2015) Obesity prevalence in Norwegian adults assessed by body mass index, waist circumference and fat mass percentage. Clinical Obesity, vol. 5, no. 4, pp. 211–218. https://doi.org/10.1111/cob.12100 (In English)

Kussin, C. (2019) The American Diabetes Association finally recommends low carb; still recommends foods that promote diabetes. Carolina Total Wellness. [Online]. Available at: https://carolinatotalwellness.com/blog/index.php/2019/09/04/the-american-diabetes-association-finally-recommends-low-carb-still-recommends-foods-that-promote-diabetes/ (accessed 10.12.2022). (In English)

LaFountain, R. A., Miller, V. J., Barnhart, E. C. et al. (2019) Extended ketogenic diet and physical training intervention in military personnel. Military Medicine, vol. 184, no. 9-10, pp. e538–e547. https://doi.org/10.1093/milmed/usz046 (In English)

Millstein, R. J., Pyle, L. L., Bergman, B. C. et al. (2018) Sex-specific differences in insulin resistance in type 1 diabetes: The CACTI cohort. Journal of Diabetes and its Complications, vol. 32, no. 4, pp. 418–423. https://doi.org/10.1016/j.jdiacomp.2018.01.002 (In English)

Minges, K. E., Whittemore, R., Grey, M. (2013) Overweight and obesity in youth with type 1 diabetes. Annual Review of Nursing Research, vol. 31, no. 1, pp. 47–69. https://doi.org/10.1891/0739-6686.31.47 (In English)

Mottalib, A., Kasetty, M., Mar, J. Y. et al. (2017) Weight management in patients with type 1 diabetes and obesity. Current Diabetes Reports, vol. 17, no. 10, article 92. https://doi.org/10.1007/s11892-017-0918-8 (In English)

Oh, R., Gilani, B., Uppaluri, K. R. (2022) Low carbohydrate diet. In: StatPearls. Treasure Island: StatPearls Publ. [Online]. Available at: https://pubmed.ncbi.nlm.nih.gov/30725769/ (accessed 17.12.2022). (In English)

Santi, E., Tascini, G., Toni, G. et al. (2019) Linear growth in children and adolescents with type 1 diabetes mellitus. International Journal of Environmental Research and Public Health, vol. 16, no. 19, article 3677. https://doi.org/10.3390/ijerph16193677 (In English)

Scott, S. N., Anderson, L., Morton, J. P. et al. (2019) Carbohydrate restriction in type 1 diabetes: A realistic therapy for improved glycaemic control and athletic performance? Nutrients, vol. 11, no. 5, article 1022. https://doi.org/10.3390/nu11051022 (In English)

Shai, I., Schwarzfuchs, D., Henkin, Y. et al. (2008) Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. The New England Journal of Medicine, vol. 359, pp. 229–241. https://doi.org/10.1056/NEJMoa0708681 (In English)

Skerrett, P. J., Willett, W. C. (2010) Essentials of healthy eating: A guide. Journal of Midwifery & Women’s Health, vol. 55, no. 6, pp. 492–501. https://doi.org/10.1016/j.jmwh.2010.06.019 (In English)

Sparks, J. R., Kishman, E. E., Sarzynski, M. A. et al. (2021) Glycemic variability: Importance, relationship with physical activity, and the influence of exercise. Sports Medicine and Health Science, vol. 3, no. 4, pp. 183–193. https://doi.org/10.1016/j.smhs.2021.09.004 (In English)

Szadkowska, A., Madej, A., Ziolkowska, K. et al. (2015) Gender and age- dependent effect of type 1 diabetes on obesity and altered body composition in young adults. Annals of Agricultural and Environmental Medicine, vol. 22, no. 1, pp. 124–128. https://doi.org/10.5604/12321966.1141381 (In English)

Thamer, C., Tschritter, O., Haap, M. et al. (2005) Elevated serum GGT concentrations predict reduced insulin sensitivity and increased intrahepatic lipids. Hormone and Metabolic Research, vol. 37, no. 4, pp. 246–251. https://doi.org/10.1055/s-2005-861411 (In English)

Tóth-Heyn, P. (2018) Szükséges és választható: lehet-e haszna a gluténmentes diétának 1-es típusú diabéteszben? [Necessary and optional: Can a gluten-free diet be beneficial in type 1 diabetes?]. Szurikata Alapitvany. [Online]. Available at: https://szurikataalapitvany.hu/videok/edukacios-eloadasok/lehet-e-haszna-a-glutenmentes-dietanak-1-es-tipusu-diabeteszben/ (accessed 16.10.2018). (In Hungarian)

Westman, E. C., Tondt, J., Maguire, E., Yancy, W. S. Jr. (2018) Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. Expert Review of Endocrinology & Metabolism, vol. 13, no. 5, pp. 263–272. https://doi.org/10.1080/17446651.2018.1523713 (In English)

Wilcox, G. (2005) Insulin and insulin resistance. The Clinical Biochemist Reviews, vol. 26, no. 2, pp. 19–39. https://pubmed.ncbi.nlm.nih.gov/16278749 (In English)

Published

2023-04-06

Issue

Section

Experimental articles