The standard approach for people with Type 1 diabetes is to match carb intake with insulin. But the argument for restricting carbs is that it keeps blood sugar more stable and requires less insulin, resulting in fewer highs and lows. The approach has not been widely studied or embraced for Type 1 diabetes, but some patients swear by it.
TypeOneGrit has about 3,000 members on Facebook who ascribe to a program devised by Dr. Richard Bernstein, an 84-year-old physician with Type 1 diabetes. His book, “Dr. Bernstein’s Diabetes Solution,” recommends limiting daily carb intake to about 30 grams, the amount in a sweet potato, large apple or two slices of whole wheat bread.
Dr. Bernstein argues that the fewer carbs consumed, the easier it is to stabilize blood sugar with insulin. He recommends foods like nonstarchy vegetables, seafood, nuts, meat, yogurt, tofu and recipes made with soybean flour, sugar substitutes and other low-glycemic ingredients. His plan emphasizes protein intake, which he says is especially important for growing children.
Dr. Carrie Diulus, an orthopedic surgeon with Type 1 diabetes who follows a low-carb vegan diet, credits the Bernstein approach with helping her keep her blood sugar under control. “It allows me to perform complex spine surgeries without worrying about my diabetes because my blood sugar stays relatively stable,” said Dr. Diulus, who helped inspire the new study when researchers learned about her participation in the TypeOneGrit community.
The most striking finding of the new report was that A1C levels, on average, fell from 7.15 percent, in the diabetic range, to 5.67 percent, which is normal. The rate of diabetes-related hospitalizations also fell, from 8 percent before the diet to 2 percent after, including fewer hospitalizations for hypoglycemic seizures.
Those following the diet had increased LDL cholesterol, likely from consuming more saturated fat, which some experts said was potentially concerning and deserved further study. But other heart disease risk factors appeared favorable: They had high HDL cholesterol, the protective kind, and low triglycerides, a type of fat in the blood linked to heart disease.
Dr. Joyce Lee, a diabetes expert at the University of Michigan who was not involved in the study, said the findings were impressive and merited further follow-up, and that patients who wanted to explore a low-carb approach might do so while being monitored by their health care team. But she also noted that the patients in the new study were a “highly motivated” group, and that it would be difficult for many people to adopt the restrictive regimen they followed.
“The reality is that it’s really hard to do low-carb, given our cultural norms,” said Dr. Lee, a professor of pediatrics at the University of Michigan.