Can a ketogenic diet be safely used to improve glycaemic control in a child with type 1 diabetes?

McClean, Anne-Marie; Montorio, Luca; McLaughlin, Diarmuid; McGovern, Shelia; Flanagan, Nuala

doi:10.1136/archdischild-2018-314973

Cited by 18 publications

(9 citation statements)

References 15 publications

(24 reference statements)

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“…Long-term outcomes of KD in patients with T1D, especially children and adolescents, are unknown [101]. Moreover, there is no consensus on the acceptable level of ketosis in patients with T1D when on a KD [101]. Nowadays we have the possibility to measure blood ketones using dedicated meters or urinary ketones using reactive stripes.…”

Section: Low-carb and Ketogenic Diets In The Treatment Of Type 1 Dmentioning

confidence: 99%

Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

et al. 2019

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Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. Studies in the literature are indeed controversial, possibly because these diets are generally poorly defined; this, together with the intrinsic complexity of dietary interventions, makes it difficult to compare results from different studies. Despite the evidence that reducing carbohydrates intake lowers body weight and, in patients with type 2 diabetes, improves glucose control, few data are available about sustainability, safety and efficacy in the long-term. In this review we explored the possible role of low-carb and ketogenic diets in the pathogenesis and management of type 2 diabetes and obesity. Furthermore, we also reviewed evidence of carbohydrates restriction in both pathogenesis of type 1 diabetes, through gut microbiota modification, and treatment of type 1 diabetes, addressing the legitimate concerns about the use of such diets in patients who are ketosis-prone and often have not completed their growth.

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Section: Low-carb and Ketogenic Diets In The Treatment Of Type 1 Dmentioning

confidence: 99%

Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

et al. 2019

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“…[ 64 ] More and more evidence has emerged in recent years demonstrating the positive effects of KD on body weight, metabolic parameters, consumption of oral antidiabetic medications, insulin resistance, and other factors in diabetic patients. [ 65 , 66 ] These trials do have significant limitations, though, including the absence of data on the long-term impacts of KD in diabetes patients, the efficacy of KD in children and adolescents with type 1 diabetes, [ 67 ] and the paucity of research on KD’s impact on microvascular complications in diabetics. [ 68 ] When evaluating the causality of KD efficacy in diabetes, some clinical studies did not evaluate ketone levels in diabetic patients during KD administration.…”

Section: Discussionmentioning

confidence: 99%

A bibliometric analysis of the global trends and hotspots for the ketogenic diet based on CiteSpace

Yao²,

Ge³

et al. 2023

Medicine

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The ketogenic diet (KD) is a potential nutritional therapy that is frequently utilized in various conditions. More and more studies are being done on KD in recent years. However, as far as we know, few studies have made an effort to offer a thorough synthesis and assessment of this topic. This paper aims to do a rigorous and thorough evaluation of the knowledge structure, development trend, and research hotspot of scientific outputs connected to KD. The bibliographic records connected to KD from January 1, 2001 to April 22, 2022 were collected using the core collection database of Web of Science. The complex data input, that consisted of the amount of publications, journals, authors, institutions, countries, keywords and cited references, was generated and analyzed visually using CiteSpace. A total of 2676 literatures on the KD were published between 2001 and 2022. The most KD-related publications were found in Epilepsia and Epilepsia Research. The authors with the most KD-related papers are Kossoff EH and Rho J. The United States is the country with the most publications, and Johns Hopkins University, Johns Hopkins University Hospital, and Johns Hopkins Medical Institutions are the institutions with the most articles. The high frequency keywords are “KD,” “ketone body,” “children,” “efficacy,” “weight loss,” “low carbohydrate diet,” “metabolism,” “epilepsy,” “beta hydroxybutyrate,” and “modified atkins diet.” The 2018 study by Kossoff EH on epilepsia and the 2017 study by Puchalska P on ketone body metabolism earned 127 and 114 citations, respectively. The results of this bibliometric analysis provide information on the state and trends in KD and may be used by researchers to pinpoint hot issues and discover new areas of study.

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“…Nutritional management in children with diabetes can improve metabolic outcomes. Ketogenic diet can reduce hyperglycemia and improve HbA1c in children with T1D, but most children discontinued this diet as intolerable (8). Parents reported different side effects such as impaired growth, delayed bone age, low energy, low mood, poor sleep, amenorrhea, hypoglycemia and elevated fasting cholesterol.…”

Section: Discussionmentioning

confidence: 99%

Nutritional issues in a diabetic patient with Kearns–Sayre syndrome

Szwilling¹,

Dżygało²,

Nowaczyk

2020

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary Kearns–Sayre syndrome (KSS) is a multi-system mitochondrial disease with wide clinical presentation. We describe the case of a 16-year-old girl with KSS accompanied by insulin-dependent diabetes, eosinophilic esophagitis (EoE), Fanconi syndrome, insufficiency of parathyroid gland and severe nutritional problems. Based on recent knowledge, ketogenic diet was introduced to improve metabolic and neurological condition, however in our patient we observed its bad consequences. Unresolved nutritional disorders forced us to proceed with esophagogastroduodenoscopy which revealed EoE. PEG procedure was performed and elemental diet with PPI’s was introduced leading to general improvement in the patient’s health condition. Learning points: Nutrition is an important factor in supportive care of patients with KSS. Ketogenic diet in patients affected by mitochondrial diseases and diabetes requires careful selection and monitoring. To the best of our knowledge, this is the first case that shows the coexistence of EoE, insulin-dependent diabetes and KSS.

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Can a ketogenic diet be safely used to improve glycaemic control in a child with type 1 diabetes?

Cited by 18 publications

References 15 publications

Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

A bibliometric analysis of the global trends and hotspots for the ketogenic diet based on CiteSpace

Nutritional issues in a diabetic patient with Kearns–Sayre syndrome

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