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The Enormous Advance Of Diabetes shocks Scientists

    Abdulaziz Sobh
    By Abdulaziz Sobh

    Categories: Health

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    Scientists may have discovered a way to reduce blood sugar levels in diabetics by putting them on a low-carbohydrate diet. A surprising new discovery suggests that diabetics can use a relatively straightforward trick to control their blood sugar levels. By adopting a very low-carbohydrate diet, people with type 1 diabetes can control their blood sugar in a way that researchers have not seen before, a great discovery that could provide hope for people with the disease. The study, published in the journal Pediatrics, examined 300 people with type 1 diabetes, 130 of whom were children. The researchers found that those who ate a diet that was very low in carbohydrates and high in protein could have a great deal of control over their blood sugar levels despite taking lower doses of insulin. They were even able to maintain average blood sugar levels at 5.67 percent, below the normal level of 5.7 percent and well below the blood sugar threshold for diabetics, which is 6.5 percent. An extremely low carbohydrate diet involves the consumption of fewer than 30 grams of carbohydrates per day, while a moderate consumption would be 130 to 225 grams per day. That means there are no foods or drinks sweetened with sugar, white bread, pasta or fruits, and vegetables with starch. The full statement of Boston Children's Hospital follows below. Very low-carbohydrate diets can improve blood sugar control in type 1 diabetes, with low rates of hypoglycemia and other complications, according to an online patient survey. The researchers, led by Belinda Lennerz, MD, Ph.D., and David Ludwig, MD, Ph.D., of Boston Children's Hospital, now request controlled clinical trials of this approach. The findings were reported today in the journal Pediatrics. The patients were drawn from TypeOneGrit, a Facebook community with type 1 diabetes committed to a very low carbohydrate diet as recommended by the book The Solution for Diabetes by Dr. Bernstein (Richard Bernstein, MD, co-author of the study). Of the 493 people who took the survey, 316 provided enough information to be included in the analysis. For 138 of these participants, the researchers were able to confirm the diagnosis of diabetes, blood sugar control measures, metabolic health measures and other outcomes with health care providers or by reviewing medical records. Forty-two percent of the participants were children. Participants reported an average daily carbohydrate intake of 36 grams, or about 5 percent of total calories (for comparison, the American Diabetes Association recommends that approximately 45 percent of calories come from carbohydrates). The self-reported values of hemoglobin A1c, the primary measure of blood sugar control, averaged over the normal range, at 5.67 percent (the target is below 7 percent and the prevailing levels average 8.2 percent). Participants needed insulin doses below the mean (average, 0.40 U / kg/day) and those for whom data were available had favorable measures of insulin sensitivity and cardiometabolic health, such as low levels of triglycerides and high levels of HDL cholesterol. Safety concerns have been raised about very low-carbohydrate diets in type 1 diabetes, mainly that they increase the risk of hypoglycemia or the dangerous drops in blood sugar. However, in the study, hospitalization rates for hypoglycemia (1 percent), diabetic ketoacidosis (2 percent), and other complications of diabetes were lower than those generally reported for type 1 diabetes populations. More than 80 percent of the respondents were satisfied or very satisfied with their diabetes management. However, about a quarter said they did not discuss the very low carb diet with their diabetes care providers, some citing concerns about being criticized or even being accused of child abuse. The authors of the study point out that severe carbohydrate restriction is actually a very old approach to type 1 diabetes. Before the discovery of insulin, it extended the lives of children, sometimes for years. Once the insulin was introduced, the carbohydrate restriction fell out of practice. But the authors believe that very low carbohydrate diets deserve further study in type 1 diabetes. Since this study was of an observational and uncontrolled nature, they request randomized clinical trials to rigorously assess the safety and efficacy of the diet. Lennerz and Ludwig emphasize that the results of this study, by themselves, do not justify a change in the management of diabetes. They strongly suggest that anyone with diabetes make dietary changes only with the supervision of a diabetes care provider. Lennerz and Ludwig are affiliated with the Division of Endocrinology and the New Balance Foundation's Obesity Prevention Center at Boston Children's Hospital and Harvard Medical School. The study was supported by the NIH National Institute of Diabetes and Digestive and Kidney Diseases. Boston Children's Hospital, the primary affiliate of pediatric education at Harvard Medical School, is home to the world's largest research company based at a pediatric medical center. Their discoveries have benefited both children and adults since 1869. Today, more than 3,000 scientists, including 8 members of the National Academy of Sciences, 17 members of the National Academy of Medicine and 11 Howard Hughes Medical Investigators, are part of the community of Boston Children's research. Founded as a 20-bed hospital for children, Boston Children's is now a comprehensive 415-bed center for pediatric and adolescent health care.