Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street, Suite 1630, Houston, TX, 77030, USA.
Baylor College of Medicine and Texas Children's Hospital, 6701 Fannin Street, Suite 1020, Houston, TX, 77030, USA.
Curr Diab Rep. 2019 Apr 27;19(6):27. doi: 10.1007/s11892-019-1153-2.
Given the challenges achieving recommended glycemic targets in youth with type 1 diabetes (T1D), providers may consider recommending carbohydrate-restricted diets (CRDs) to optimize glycemic control. The goal of the present review is to describe relevant literature on the potential medical and psychosocial benefits and risks of CRDs in youth with T1D.
Limited data exist on the effects of CRDs in pediatric populations. Findings from studies with youth and adults are mixed; some indicate that CRDs may be associated with desirable medical outcomes, such as improved glycemic control and reduced HbA1c, which may contribute to positive psychological outcomes such as reduced diabetes distress and depressive symptoms. Others suggest that CRDs may also be associated with detrimental outcomes, including mineral deficiencies and suboptimal growth, and dietary restriction has been linked to greater diabetes distress, disordered eating, and diabetes management. More research is needed to evaluate benefits and risks of CRDs in youth. Providers should exercise caution when discussing CRDs with youth and families, particularly when considering CRDs for youth at elevated risk for eating disordered behavior.
鉴于在青少年 1 型糖尿病（T1D）患者中实现推荐的血糖目标存在挑战，临床医生可能会考虑推荐碳水化合物限制饮食（CRD）以优化血糖控制。本综述的目的是描述青少年 T1D 患者中 CRD 的潜在医学和心理社会获益和风险的相关文献。
关于儿科人群中 CRD 的影响的数据有限。来自青少年和成人研究的结果参差不齐；一些研究表明，CRD 可能与理想的医疗结果相关，例如改善血糖控制和降低 HbA1c，这可能有助于改善心理健康结果，如减少糖尿病困扰和抑郁症状。其他研究表明，CRD 也可能与不良结果相关，包括矿物质缺乏和生长不良，并且饮食限制与更大的糖尿病困扰、饮食失调和糖尿病管理有关。需要更多的研究来评估 CRD 在青少年中的获益和风险。临床医生在与青少年及其家庭讨论 CRD 时应谨慎，特别是在考虑对有饮食失调行为风险的青少年使用 CRD 时。
