Medical management of children with type 1 diabetes on low-carbohydrate or ketogenic diets
| Autor: | Amy A. Rydin, Lauren Oswald, Anne Kaess, Kimber M. Simmons, Darcy Owen, Brigitte I. Frohnert, Gail Spiegel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment Nutritional Status 030209 endocrinology & metabolism Bone health Article 03 medical and health sciences Epilepsy Diet Carbohydrate-Restricted 0302 clinical medicine Clinical Protocols Patient Education as Topic Poor linear growth Internal Medicine medicine Humans 030212 general & internal medicine Low carbohydrate Intensive care medicine Child Glycemic Protocol (science) Type 1 diabetes business.industry medicine.disease Diabetes Mellitus Type 1 Pediatrics Perinatology and Child Health business Diet Ketogenic Ketogenic diet |
| Zdroj: | Pediatr Diabetes |
| Popis: | Objectives Low-carbohydrate and ketogenic diets are becoming increasingly popular choices for people with type 1 diabetes (T1D) aiming to achieve optimal glycemic control. A carbohydrate-restricted diet in children has been associated with negative health effects including poor linear growth and inadequate bone mineralization. Guidelines for monitoring children and adolescents choosing to follow a carbohydrate-restricted diet do not exist. We aimed to create a clinical protocol outlining how to clinically and biochemically follow patients choosing a carbohydrate-restricted diet with the goal of medical safety. Methods An interdisciplinary committee was formed and reviewed current consensus guidelines for pediatric patients on carbohydrate-restricted diets for epilepsy and metabolic disorders. A literature search was done to determine management strategies for children with T1D on a low-carbohydrate or ketogenic diet. Key health parameters that require monitoring were identified: growth, glycemic control, bone health, cardiometabolic health, and nutritional status. These health outcomes were used to develop a protocol for monitoring children on carbohydrate-restricted diets. Results A one-page protocol for medical providers and educational materials for families interested in following a low-carbohydrate or ketogenic diet were developed and successfully implemented into clinical care. Conclusion Implementing a protocol for children on carbohydrate-restricted diets in clinic allows medical providers to ensure medical safety while being open to discussing a family's dietary preferences. Following children in the protocol over time will lead to informed clinical guidelines for patients with T1D who choose to follow a carbohydrate-restricted diet. |
| Databáze: | OpenAIRE |
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