Noakes had a point, about diabetes and carbs that is ...
Researchers find that type 1 diabetics who follow a very-low carb diet show an improvement in their blood sugar control
Very-low carb diets show potential in improving the blood sugar control among adults and children with type 1 diabetes, a new study found.
US researchers found exceptional sugar control and low rates of complications like hypoglycaemia among 300 people in the observational study, reported in the journal Pediatrics on Monday. Over 40% of the participants were children.
They were eating only 36 grams of carbohydrates over two years on average daily, amounting to about five percent of their total calories. The American Diabetes Association recommends about 45% of calories come from carbs.
Researchers Dr Belinda Lennerz and Dr David Ludwig, of Boston Children’s Hospital, do not suggest a change in diabetes management based on these results but they recommend doing scientific clinical trials on managing type 1 diabetes with this approach.Catherine Rice, the mother of 12-year-old Maya who has type 1 diabetes, said on Monday that following a low-carb diet for the past year had transformed her life by stabilising her blood sugar levels.
Maya made the decision herself when they were attending a type 1 diabetes conference in the US last June.
“She walked out (after an eye test which showed slight damage) and said I’m never eating carbs again.
“Over the years it has been a rollercoaster and every day has been unpredictable and every day has been terrifying,” said Rice, talking about Maya’s health before she switched to the low-carb diet.
She said Maya often used to be hypoglycaemic, but this is no longer a problem. She dictates her carb intake and even refuses birthday cake.Rice said: “Our doctor agreed to allow her on this diet (of less than 30g of carb a day) but he does growth analysis and support.”
Dr David Segal, a paediatric endocrinologist in Johannesburg, said there was good evidence that limiting carbs resulted in better blood sugar and he had no medical concerns about it.
“If you’re putting carbs in a body without a working pancreas, you are always swimming upstream with lots of highs and lows in blood sugar.
“In this study they said: ‘Let’s switch your fuel source and live on fats and protein, and you will get better blood sugars.’ They used diet and exercise to control blood sugars and took insulin to stay alive.”
But Segal said that an ultra-low carb diet is difficult to follow and “you don’t get anywhere if you dabble in it”.
“You can’t play on both sides. You have to stick to ultra-low carb like a cult (to control blood sugar). And how long can you tolerate living completely separately from the rest of the world?” he said.
“A lot of eating is a social function. It is a big mind shift.”Segal said they have had patients who gave up the ultra-low carb diet because it was too onerous, and also highly competitive athletes who found it did not work for them.
He said they do recommend a lower carbohydrate intake for people with diabetes.
UCT professor Tim Noakes is a zealous supporter of low-carb diets for managing type 2 diabetes and weight loss, and roughly half a million South Africans say they follow the “Banting diet” which he has popularised.
Participants in the US research were following the low-carb diet recommended by Dr Richard Bernstein, who is a co-author on this study.
Their self-reported blood-sugar control was in the normal range on average and they required “lower-than-average” doses of insulin compared to type 1 diabetes on a normal diet.“Safety concerns have been raised about very-low carb diets in type 1 diabetes, primarily that they increase the risk of hypoglycaemia, or dangerous drops in blood sugar,” the authors said, reporting however that the rates of hospitalisation for hypoglycaemia were lower than those generally reported among type 1 diabetics.
About a quarter of the participants said they “did not discuss the very-low carb diet with their diabetes care providers, some citing concerns about being criticised or even being accused of child abuse”. No stunted growth was reported in this group.
The authors said carb restriction was used long ago to control type 1 diabetes and extend children’s lives before insulin was discovered.