Managing type 1 diabetes mellitus with a ketogenic diet

Summary Traditional guidelines for type 1 diabetics do not restrict carbohydrates to improve clinical outcomes for patients. This paper highlights the favorable blood glucose control outcomes when a type 1 diabetic focuses on caloric intake from protein and healthy fats instead of the traditional carbohydrate-focused meals. We followed a male type 1 diabetic in his 20s adopting a ketogenic diet through a process of slowly lowering total daily carbohydrate intake. Diabetes-related biomarkers were measured throughout the process. Diabetes-related biomarkers saw massive improvements and ended up in the official non-diabetic range. Total daily insulin requirements dropped by 70%. The patient also experienced great improvements in his quality of life. This study demonstrates the possibility of improving diabetes-related biomarkers through dietary changes, which have positive effects on health outcomes in patients living with this disease. Learning points The adaptation of a ketogenic diet improved diabetes-related biomarkers in this patient. Diabetes-related biomarkers, such as HbA1c, are the main risk factors for developing complications in diabetics. The ketogenic diet is a feasible approach to minimizing the risk of developing complications in diabetics. Total daily insulin requirements dropped by 67% adapting a ketogenic diet. The patient experienced enormous changes in the quality of life after adapting to the new diet. The safe and physiological state of ketosis might be associated with additional benefits for the patient

[1]  I. Hirsch,et al.  The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) , 2021, Diabetologia.

[2]  B. Nordestgaard,et al.  Impact of Glucose Level on Micro- and Macrovascular Disease in the General Population: A Mendelian Randomization Study , 2020, Diabetes Care.

[3]  L. Piemonti,et al.  Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes , 2019, Nutrients.

[4]  M. B. Christensen,et al.  Low versus high carbohydrate diet in type 1 diabetes: A 12‐week randomized open‐label crossover study , 2019, Diabetes, obesity & metabolism.

[5]  D. Maahs,et al.  Obesity in Type 1 Diabetes: Pathophysiology, Clinical Impact, and Mechanisms. , 2018, Endocrine reviews.

[6]  C. Ebbeling,et al.  Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet , 2018, Pediatrics.

[7]  F. Villamena,et al.  Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health , 2018, Journal of nutrition and metabolism.

[8]  M. Sakharkar,et al.  Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients , 2016, Biomarker insights.

[9]  Z. Clemens,et al.  A child with type 1 diabetes mellitus (T1DM) successfully treated with the Paleolithic ketogenic diet: A 19-month insulin-freedom , 2015 .

[10]  G. Steil,et al.  Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1 Diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era , 2015, Diabetes Care.

[11]  N. Wareham,et al.  Epidemiology of diabetes , 2014, Medicine.

[12]  Z. Clemens,et al.  Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet , 2014 .

[13]  P. O S I T I O N S T A T E M E N T,et al.  Diagnosis and Classification of Diabetes Mellitus , 2011, Diabetes Care.

[14]  J. Freeman.  Insulin Analog Therapy: Improving the Match With Physiologic Insulin Secretion , 2009, The Journal of the American Osteopathic Association.

[15]  J. McGarry,et al.  The metabolic derangements and treatment of diabetic ketoacidosis. , 1983, The New England journal of medicine.

[16]  P. Pozzilli,et al.  Epidemiology and Risk Factors of Type 1 Diabetes , 2018 .

[17]  J. Rosenbauer,et al.  Metabolic control as reflected by HbA1c in children, adolescents and young adults with type-1 diabetes mellitus: combined longitudinal analysis including 27,035 patients from 207 centers in Germany and Austria during the last decade. , 2008, European journal of pediatrics.