Safety and Efficacy of Eucaloric Very Low-Carb Diet (EVLCD) in Type 1 Diabetes: A One-Year Real-Life Retrospective Experience

Andrea Kleiner, Barbara Cum, Livia Pisciotta, Ivan Raffaele Cincione, Ludovica Cogorno, Amalia Prigione, Antonio Tramacere, Andrea Vignati, Luca Carmisciano, Samir Giuseppe Sukkar, Andrea Kleiner, Barbara Cum, Livia Pisciotta, Ivan Raffaele Cincione, Ludovica Cogorno, Amalia Prigione, Antonio Tramacere, Andrea Vignati, Luca Carmisciano, Samir Giuseppe Sukkar

Abstract

A eucaloric very low carbohydrate diet (EVLCD) is a diet with a daily caloric intake equal to the total daily energy expenditure (TDEE) with a carbohydrate content of <50 g/day. The literature on very low carbohydrate diets (VLCD) in type 1 diabetes (DM 1) is limited, although recently published scientific studies have highlighted their safety and efficacy in managing DM 1. In this retrospective analysis, we report the clinical data of 33 patients affected by DM 1 carrying out insulin therapy who switched voluntarily from their usual diet (high carb, low fat) to an EVLCD. Our aim is to evaluate the glycemic control, the amount of insulin needed in order to maintain glycemic control and safety of EVLCD. The switch improved glycemic control (mean glycated hemoglobin decreased from 8.3% to 6.8% (p < 0.01). The number of patients who reached a glycated hemoglobin value of <7% increased statistically from 12% to 57% (p < 0.01), and there was a statistically significant decrease (p < 0.01) in the units of daily insulin (from 36.7± 14.9 IU to 28.9 ±9.1 IU) A reduction from 54% to 24% in clinical level 2 hypoglycemia episodes was reported. No cases of severe hypoglycemia or ketoacidosis were observed. The results of the study support that EVLCD in DM 1 seems safe and effective when adopted under tight medical supervision.

Keywords: DM1; EVLCD; eucaloric very low-carb diet; safety; type 1 diabetes.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Visual representation of the total amount of Kcal and of the proportion of carb, fat, and protein in usual diet and in EVLCD.
Figure 3
Figure 3
Percentage distribution of the glycated hemoglobin classes of the 33 patients of the study.
Figure 4
Figure 4
Boxplot represents HbA1c levels before and after EVLCD. Each point represents a single measurement, and the solid lines connects the two measurements of each patient.

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