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Nutrients. 2019 May 7;11(5). pii: E1022. doi: 10.3390/nu11051022.

Carbohydrate Restriction in Type 1 Diabetes: A Realistic Therapy for Improved Glycaemic Control and Athletic Performance?

Author information

1
School of Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada. sam-scott@live.co.uk.
2
Independent Researcher, Toronto, ON M3J 1P3, Canada. lo.anderson16@gmail.com.
3
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK. j.p.morton@ljmu.ac.uk.
4
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK. a.j.wagenmakers@ljmu.ac.uk.
5
School of Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada. mriddell@yorku.ca.
6
LMC Diabetes & Endocrinology, 1929 Bayview Avenue, Toronto, ON M4G 3E8, Canada. mriddell@yorku.ca.

Abstract

Around 80% of individuals with Type 1 diabetes (T1D) in the United States do not achieve glycaemic targets and the prevalence of comorbidities suggests that novel therapeutic strategies, including lifestyle modification, are needed. Current nutrition guidelines suggest a flexible approach to carbohydrate intake matched with intensive insulin therapy. These guidelines are designed to facilitate greater freedom around nutritional choices but they may lead to higher caloric intakes and potentially unhealthy eating patterns that are contributing to the high prevalence of obesity and metabolic syndrome in people with T1D. Low carbohydrate diets (LCD; <130 g/day) may represent a means to improve glycaemic control and metabolic health in people with T1D. Regular recreational exercise or achieving a high level of athletic performance is important for many living with T1D. Research conducted on people without T1D suggests that training with reduced carbohydrate availability (often termed "train low") enhances metabolic adaptation compared to training with normal or high carbohydrate availability. However, these "train low" practices have not been tested in athletes with T1D. This review aims to investigate the known pros and cons of LCDs as a potentially effective, achievable, and safe therapy to improve glycaemic control and metabolic health in people with T1D. Secondly, we discuss the potential for low, restricted, or periodised carbohydrate diets in athletes with T1D.

KEYWORDS:

carbohydrate; carbohydrate periodisation; exercise training; glycaemia; hypoglycaemia; insulin; low carbohydrate diet; train low; type 1 diabetes; very low carbohydrate diet

PMID:
31067747
DOI:
10.3390/nu11051022
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