Department of Pediatrics, 2(nd) Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia, Czech Republic.
Department of Pediatrics, 2(nd) Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia, Czech Republic.
Diabetes Res Clin Pract. 2024 Nov;217:111844. doi: 10.1016/j.diabres.2024.111844. Epub 2024 Sep 3.
We investigated whether a short period of tightly controlled low-carbohydrate diet (LCD) leads to higher time in range without increasing the associated risks in children and young people with diabetes (CYPwD).
Thirty-five (CYPwD) were recruited into this randomized controlled cross-over study (20 female; 20 CSII; age 14.5 ± 2.9 years; HbA1c 48.9 ± 9.4 mmol/mol). The interventions were five and five weeks of ready-made food box deliveries of isocaloric diets in random order: either LCD (94.5 ± 4.7 g/day) or recommended carbohydrate diet (RCD) (191 ± 19.2 g/day). The outcomes were continuous glucose monitoring parameters, anthropometric, laboratory and quality of life (QoL) data.
Time in range was significantly higher in the LCD than in the RCD period (77.1 % vs. 73.8 %, P=0.008). Times in hyperglycemia and average glycaemia were significantly lower in the LCD. There was no difference between the diets in time in hypoglycemia or glycemic variability. The subjects' body weight and BMI were significantly lower during the LCD. There was no significant difference in the LDL-cholesterol levels. No significant differences were observed in the self-assessed QoL.
Short-term LCD led to an improvement of glycemic parameters without increasing time in hypoglycemia, disturbing the lipid profile or negatively affecting the quality of life of CYPwD.
我们旨在研究短期严格控制的低碳水化合物饮食（LCD）是否会使儿童和青少年糖尿病患者（CYPwD）的血糖控制达标时间更长，而不会增加相关风险。
本随机对照交叉研究纳入了 35 名（CYPwD；20 名女性；20 名胰岛素泵使用者；年龄 14.5±2.9 岁；HbA1c 48.9±9.4mmol/mol）患者。干预措施为随机顺序进行的为期五周和五周的即食食品盒供应等热量饮食：要么是 LCD（94.5±4.7g/天），要么是推荐的碳水化合物饮食（RCD）（191±19.2g/天）。结局指标为连续血糖监测参数、人体测量学、实验室和生活质量（QoL）数据。
与 RCD 期相比，LCD 期血糖控制达标时间显著更高（77.1% vs. 73.8%，P=0.008）。LCD 期高血糖和平均血糖水平显著更低。低血糖和血糖变异性在两种饮食之间无差异。在 LCD 期间，受试者的体重和 BMI 显著降低。LDL 胆固醇水平无显著差异。自我评估的 QoL 也没有显著差异。
短期 LCD 可改善血糖参数，而不会增加低血糖时间，不会干扰血脂谱，也不会对 CYPwD 的生活质量产生负面影响。
