Like many children, Andrew Hightower, 13, likes pizza, sandwiches and dessert.
But Andrew has Type 1 diabetes, and six years ago, to control his blood sugar levels, his parents put him on a low-carbohydrate, high-protein diet. His mother makes him recipes with diabetic-friendly ingredients that won’t spike his blood sugar, such as pizza with a low-carb, almond-flour crust and homemade bread with walnut flour instead of white flour.
Andrew’s diet requires careful planning. But he and his parents say it makes it easier to manage his condition, and since he started the diet, his blood sugar control has markedly improved and he has had no complications requiring hospital visits.
“I do this so that I can be healthy,” said Andrew, who lives in Jacksonville, Fla.
Most diabetes experts do not recommend low-carb diets for people with Type 1 diabetes, especially children. Some worry that restricting carbs can lead to dangerously low blood sugar levels, a condition known as hypoglycemia, and potentially stunt growth. But a new study published in the journal Pediatrics suggests otherwise.
It found that children and adults with Type 1 diabetes who followed a very low-carb, high-protein diet for an average of just more than two years — combined with the diabetes drug insulin at smaller doses than typically required on a normal diet — had “exceptional” blood sugar control. They had low rates of major complications, and children who followed it for years did not show any signs of impaired growth.
The study found that the participants’ average hemoglobin A1C, a long-term barometer of blood sugar levels, fell to just 5.67 percent. An A1C under 5.7 is considered normal, and it is well below the threshold for diabetes, which is 6.5 percent.
“Their blood sugar control seemed almost too good to be true,” said Belinda Lennerz, the study’s lead author and a pediatric endocrinology instructor at Boston Children’s Hospital and Harvard Medical School. “It’s nothing we typically see in the clinic for Type 1 diabetes.”
The study comes with an important caveat. It was an observational study, not a randomized trial with a control group.
About 1.25 million Americans have Type 1 diabetes, which occurs when the pancreas does not produce enough insulin to regulate blood sugar levels. Managing the condition requires administering insulin throughout the day. Over time, chronically elevated blood sugar can lead to nerve and kidney damage and cardiovascular disease.
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 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.