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Medical and Psychological Considerations for Carbohydrate-Restricted Diets in Youth With Type 1 Diabetes

  • Psychosocial Aspects (SS Jaser, Section Editor)
  • Published:
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Abstract

Purpose of Review

Given the challenges achieving recommended glycemic targets in youth with type 1 diabetes (T1D), providers may consider recommending carbohydrate-restricted diets (CRDs) to optimize glycemic control. The goal of the present review is to describe relevant literature on the potential medical and psychosocial benefits and risks of CRDs in youth with T1D.

Recent Findings

Limited data exist on the effects of CRDs in pediatric populations. Findings from studies with youth and adults are mixed; some indicate that CRDs may be associated with desirable medical outcomes, such as improved glycemic control and reduced HbA1c, which may contribute to positive psychological outcomes such as reduced diabetes distress and depressive symptoms. Others suggest that CRDs may also be associated with detrimental outcomes, including mineral deficiencies and suboptimal growth, and dietary restriction has been linked to greater diabetes distress, disordered eating, and diabetes management.

Summary

More research is needed to evaluate benefits and risks of CRDs in youth. Providers should exercise caution when discussing CRDs with youth and families, particularly when considering CRDs for youth at elevated risk for eating disordered behavior.

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Acknowledgements

The authors would like to thank Viena Cao for her assistance with preparing this manuscript.

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Authors and Affiliations

  1. Baylor College of Medicine and Texas Children’s Hospital, 6701 Fannin Street, Suite 1630, Houston, TX, 77030, USA

    Katherine A. S. Gallagher

  2. Baylor College of Medicine and Texas Children’s Hospital, 6701 Fannin Street, Suite 1020, Houston, TX, 77030, USA

    Daniel DeSalvo

  3. Vanderbilt University School of Medicine, 1500 21st Ave, Suite 1514, Nashville, TN, 37212, USA

    Justin Gregory

  4. Baylor College of Medicine and Texas Children’s Hospital, 1102 Bates Ave, Suite 940, Houston, TX, 77030, USA

    Marisa E. Hilliard

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  1. Katherine A. S. Gallagher
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Correspondence to Marisa E. Hilliard.

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Katherine A.S. Gallagher, Justin Gregory, and Marisa E. Hilliard declare that they have no conflicts of interest.

Daniel DeSalvo reports grants from Helmsley Charitable Trust and the US Food and Drug Administration; and personal fees from Insulet, Dexcom, and Bigfoot Biomedical.

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Gallagher, K.A.S., DeSalvo, D., Gregory, J. et al. Medical and Psychological Considerations for Carbohydrate-Restricted Diets in Youth With Type 1 Diabetes. Curr Diab Rep 19, 27 (2019). https://doi.org/10.1007/s11892-019-1153-2

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