Does a Low-Carb Diet Reduce Insulin Requirements in Type 1 Diabetes? Unpacking the Research and Real-World Experience

📨 In response to a recent post by Will and Goody- Our SMART CARB Life (https://www.facebook.com/WillandGoodySMARTcarb/posts/pfbid021bd34vdnifUWF4sgqApvfjaBK6z998714VX7KcmbG7QkxPpN7LkrqFXSKkB33a5Nl), a mother asked the following question regarding a statement made by her medical team:

💬“What is your response to this comment I keep hearing:

‘It’s important to know that low-carb diets don’t always mean less insulin. Low-carb diets frequently increase insulin resistance.’”

▶️ Today, let’s unpack the first part of the comment: “…low-carb diets don’t always mean less insulin.”

Transitioning to a low-carb diet can often feel like stepping into a world of unknowns, especially when managing Type 1 diabetes (T1D). Questions arise from families and individuals about how dietary changes might impact insulin needs, glycemic control, and overall health. One common concern shared by medical teams is: “Low-carb diets don’t always mean less insulin.”

Is this statement backed by science? 🤔

What do we know from the research, and what does real-world experience tell us about the relationship between carbohydrate intake and insulin requirements? In this blog, we’ll break down both the physiological basis and the research studies to shed light on this important question. 💡

Understanding the Physiology: Carbohydrates, Blood Sugar, and Insulin

First, let’s revisit the basic physiology of carbohydrate metabolism in Type 1 diabetes. 🍞🍎

When carbohydrates are consumed, they are broken down into glucose, which enters the bloodstream, causing a rise in blood sugar levels. For individuals with Type 1 diabetes, either injected insulin 💉 or the body’s own insulin must be administered to help shuttle glucose into cells for energy or storage.

Logically, it follows that reducing carbohydrate intake means less glucose entering the bloodstream, which should lower the amount of insulin needed to manage post-meal blood sugar spikes. The big question is: Does this relationship hold up in practice? 🤷‍♀️

Research-Backed Evidence: Lowering Carbs, Lowering Insulin Requirements

Let’s dive into the research 🧑‍🔬, starting with several key studies that have investigated whether reducing carbohydrate intake directly impacts insulin requirements in individuals with Type 1 diabetes.

Neuman et al. (2024)

📊 A study by Neuman et al. (2024) offers insightful data for families managing T1D. This crossover study, involving children and young people with Type 1 diabetes, examined the effects of following a low-carb diet (LCD). The results were striking: insulin needs dropped from 0.77 to 0.58 units/kg/day—a 25% reduction! 🔥 Importantly, this reduction was achieved while maintaining stable blood glucose levels and avoiding hypoglycemia. These findings align with the physiological expectation that fewer carbs mean less glucose in the bloodstream, thus reducing the insulin needed for management.

👉 Key takeaway: Reducing dietary carbohydrates leads to a significant drop in insulin needs without compromising glycemic control in young people with Type 1 diabetes.

Lennerz et al. (2018)

📉 In a study conducted by Lennerz et al. (2018), children on a very low-carbohydrate diet (VLCD) reduced their insulin doses by 30% while maintaining exceptional glycemic control, with HbA1c levels around 5.67% ⭐️. This is especially impressive given that typical HbA1c targets for individuals with T1D range from 6.5% to 7.5%. The study demonstrates that a VLCD enables children with T1D to achieve near-normal blood glucose levels with significantly lower insulin requirements.

👉 Key takeaway: A VLCD allows for a substantial reduction in insulin while improving overall glycemic control, helping patients maintain HbA1c levels in the near-normal range.

Turton et al. (2018)

Turton et al. (2018) focused on adults with T1D who implemented a low-carb diet. On average, insulin requirements dropped by 27%, while participants saw improved glycemic control, with fewer blood sugar spikes. 📉 This study emphasizes that even moderate carbohydrate restriction can have a profound impact on insulin needs and blood sugar stability.

👉 Key takeaway: Moderate carbohydrate restriction leads to a significant decrease in insulin requirements, contributing to better glycemic control and reducing blood sugar fluctuations.

Mahmood et al. (2023)

In a clinical trial by Mahmood et al. (2023), individuals with T1D on a low-carb diet required 24% less insulin than those on a higher-carb diet. 💡 The reduction was both statistically significant and clinically relevant, showing that a low-carb diet helps to minimize insulin requirements while maintaining glycemic stability.

👉 Key takeaway: Reducing carbohydrate intake results in significantly lower insulin requirements, supporting the physiological basis of fewer carbs equaling less insulin.

Schmidt et al. (2019)

Schmidt et al. (2019) demonstrated that participants who reduced their carbohydrate intake saw a 20% reduction in daily insulin doses, including both bolus (mealtime) and basal (background) insulin 💉. This reduction applied across all insulin types, further proving that lowering carb intake reduces the overall need for insulin.

👉 Key takeaway: Lowering carbs not only reduces mealtime insulin requirements but also basal insulin doses, contributing to an overall reduction in insulin usage.

Kleiner et al. (2023)

A study by Kleiner et al. (2023) showed that participants on a low-carb diet saw their insulin needs drop from 36.7 ± 14.9 IU to 28.9 ± 9.1 IU, a significant reduction 📉. Along with fewer insulin needs, participants also reported increased energy and more stable blood sugar levels.

👉 Key takeaway: A low-carb diet leads to a measurable decrease in daily insulin requirements, alongside improvements in energy and blood sugar stability.

Real-World Experience: Translating Research into Practice

Research is clear: reducing carbohydrate intake leads to lower insulin requirements in individuals with Type 1 diabetes. But what about real-world experience? 🤔 Many families in the T1D community have shared personal stories of how a low-carb or very low-carb diet has transformed their diabetes management.

By reducing carbohydrate intake, many report more predictable blood sugar levels, fewer episodes of hypoglycemia, and smoother day-to-day management. The reduction in insulin requirements results in fewer post-meal blood sugar spikes and crashes, allowing individuals to feel more in control of their diabetes and enjoy improved quality of life. ✨

Key Takeaways from the Research

The evidence is clear: lowering carbohydrate intake can significantly reduce insulin requirements in individuals with Type 1 diabetes. 📉 From Neuman’s 25% reduction in insulin needs to Lennerz’s 30% decrease, the data consistently shows that low-carb and very low-carb diets can lead to meaningful changes in diabetes management.

These results are not only supported by clinical trials but also by real-world experiences from individuals and families managing Type 1 diabetes.

Conclusion: Empowering Families with Evidence-Based Information

When it comes to managing Type 1 diabetes, it’s essential for families to have access to accurate, evidence-based information. 📚 Reducing carbohydrate intake can lower insulin requirements and improve glycemic control, providing families with a powerful tool to manage the condition.

For those considering a low-carb or very low-carb approach, it’s important to work closely with healthcare providers to tailor the strategy to individual needs. 🩺 This includes adjusting insulin doses, monitoring blood glucose levels carefully, and making gradual dietary changes to ensure the transition is smooth and effective.

As the research shows, a low-carb diet isn’t just about reducing insulin—it’s about improving quality of life and achieving better control over diabetes. With the right approach, families can navigate the challenges of Type 1 diabetes with confidence, armed with the knowledge that they are doing everything possible to support long-term health and well-being. 💙

References

Neuman, V., Plachy, L., Drnkova, L., Pruhova, S., Kolouskova, S., Obermannova, B., … Sumnik, Z. (2024). Low-carbohydrate diet in children and young people with type 1 diabetes: A randomized controlled trial with cross-over design. Diabetes Research and Clinical Practice, 217, 111844. doi:10.1016/j.diabres.2024.111844

Lennerz, B. S., Barton, A., Bernstein, R. K., Dikeman, R. D., Diulus, C., Hallberg, S., ... & Westman, E. C. (2018). Management of type 1 diabetes with a very low–carbohydrate diet. Pediatrics, 141(6), e20173349. https://doi.org/10.1542/peds.2017-3349

Turton, J. L., Raab, R., & Rooney, K. B. (2018). Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review. PLOS ONE, 13(3). doi:10.1371/journal.pone.0194987

Turton, J. L., Brinkworth, G. D., Parker, H. M., Lim, D., Lee, K., Rush, A., … Rooney, K. B. (2023). Effects of a low-carbohydrate diet in adults with type 1 diabetes management: A single arm non-randomised clinical trial. PLOS ONE, 18(7). doi:10.1371/journal.pone.0288440

Shaker Mahmood, B. (2023). Impact of low carbohydrate diet on patients with type 1 diabetes. E3S Web of Conferences, 391, 01132. doi:10.1051/e3sconf/202339101132

Schmidt, S., Christensen, M. B., Serifovski, N., Damm-Frydenberg, C., Jensen, J. B., Fløyel, T., Størling, J., Ranjan, A., & Nørgaard, K. (2019). Low versus high carbohydrate diet in type 1 diabetes: A 12-week randomized open-label crossover study. Diabetes, obesity & metabolism, 21(7), 1680–1688. https://doi.org/10.1111/dom.13725

Kleiner A, Cum B, Pisciotta L, Cincione IR, Cogorno L, Prigione A, Tramacere A, Vignati A, Carmisciano L, Sukkar SG. Safety and Efficacy of Eucaloric Very Low-Carb Diet (EVLCD) in Type 1 Diabetes: A One-Year Real-Life Retrospective Experience. Nutrients. 2022; 14(15):3208. https://doi.org/10.3390/nu14153208