Discussion
ketoacidosis, T2D, hypoglycaemia, macrovascular complications, T1D, diabetes
DIABETES, KETOACIDOSIS, HYPOGLYCAEMIA
This single-arm longitudinal intervention study showed that a healthcare professional supported 12-week LC diet (25–75 g/day) improved markers of blood glucose control and quality of life with reduced total daily insulin dosages and no reported episodes of ketoacidosis or severe hypoglycaemia. These preliminary results suggest that a professionally supported LC diet may be a safe and effective approach for T1D management, yet larger randomised controlled trials are needed to confirm our findings.The 0.6% reduction in mean HbA1c levels observed during the intervention period is considered relatively large and clinically significant, considering that post-intervention HbA1c levels were 7.1% (54 mmol/mol) with 44% of participants reaching the diabetes target of HbA1c ≤7.0% (≤53 mmol/mol) [GV is increasingly recognised as a useful indicator for risk of micro- and macrovascular complications in T1D [Interestingly, a modest but clinically significant reduction in body weight (3%, -2.4 kg) during the 12-week LC diet was observed. This is consistent with LC diet studies conducted in T2D populations [There are several often cited potential safety concerns regarding the use of LC diets including increased risk of hypoglycaemia in T1D [Improvements in glycaemic control observed with LC diets are often dismissed by concomitant increases in LDL-cholesterol (LDL) levels reported in some [A strength of the current study is that it was conducted in a real-world remote care setting that improves translatability into clinical practice. The intervention was delivered by a registered dietitian via remote contact, and participants were not required to travel outside of their local area for outcome measurements. With consideration of the recent transition toward Telehealth services [The study has several limitations. The single-arm longitudinal study design precludes the ability to directly compare the effects of a LC diet intervention to a HC diet intervention, and the relatively small sample size and short follow-up period (12 weeks) reduces generalisability of the present findings. However, while not a randomised controlled trial, the current within-participant controlled intervention study assists to minimise the potential influences of inherent individual differences of diet and non-diet factors that influence T1D management and blood glucose levels [In the present study, the LC diet intervention prescribed the consumption of minimally-processed whole foods and to minimise the intake of ultra-processed foods. However, due to the preliminary nature of this single arm study that did not assess diet quality, it is difficult to determine the specific effect(s) of changes in diet quality on the favourable metabolic changes observed. Prioritisation of minimally-processed foods has been identified as a core feature of safe and effective LC diet interventions used in T2D management [