Debunking Myths and Understanding the Facts: The Role of Low-Carb Diets in Type 1 Diabetes Management

Low-carbohydrate diets (LCDs) have been studied for nearly three decades, with thousands of clinical trials demonstrating their effectiveness for managing metabolic disorders, including obesity, Type 2 diabetes, cardiovascular disease, and hypertension. Despite this growing body of evidence, misinformation and misconceptions persist, particularly in the realm of Type 1 diabetes (T1D).

These dietary approaches, which include Therapeutic Carbohydrate Reduction (TCR), Ketogenic Diets (KD), Very Low-Carbohydrate Diets (VLCDs), Low-Carbohydrate High-Fat (LCHF) Diets, and Carbohydrate-Restricted Diets, have gained increasing recognition within the medical and scientific communities. Major organizations, such as the American Diabetes Association (ADA), Diabetes Canada, and the European Association for the Study of Diabetes (EASD), now acknowledge LCDs as an effective strategy for managing Type 2 diabetes. However, guidance on their application to T1D remains limited, leading to confusion and hesitation among healthcare professionals and individuals living with T1D.

The recently published study, Myths and Facts Regarding Low-Carbohydrate Diets by Teicholz et al. (2025), provides a comprehensive evaluation of the existing evidence surrounding LCDs, systematically debunking common concerns and highlighting the scientific validity of this dietary approach. The authors, a group of leading clinicians and researchers, critically examined long-standing claims regarding heart disease, kidney function, metabolic health, nutritional adequacy, and sustainability. The study's findings reinforce that LCDs are not merely a fad diet, but a clinically supported intervention with well-documented metabolic benefits.

For individuals living with T1D, understanding the role of carbohydrate reduction is particularly critical. Many people successfully achieve stable, normal blood glucose levels and reduce glucose variability and insulin requirements through the implementation of a tailored TCR nutrition strategy or other forms of carbohydrate-reduction ways of eating. However, misinformation about low-carb diets often deters individuals and families from considering them as a viable strategy for managing T1D.

This article will explore the key findings from Teicholz et al. (2025) and discuss their implications for T1D management, particularly for parents of children with T1D and adults navigating their own diabetes journey. By addressing common misconceptions and providing evidence-based insights, we aim to equip the T1D community with the knowledge needed to make informed dietary decisions.

What is a Low-Carbohydrate Diet?

Low-carbohydrate diets (LCDs) encompass a range of dietary patterns that reduce carbohydrate intake while emphasizing protein and fat as primary macronutrients. According to Teicholz et al. (2025), leading researchers and practitioners have established clear definitions of LCDs:

📌 Low-Carbohydrate Diet (LCD): ≤130g of carbohydrates per day (or ≤25% of total daily calories)
📌 Ketogenic Diet (KD): ≤50g of carbohydrates per day (or ≤10% of total daily calories)

These definitions are widely accepted in clinical and research settings, particularly in metabolic health and diabetes management. LCDs, including Therapeutic Carbohydrate Reduction (TCR), are frequently used to improve glycemic control, reduce insulin resistance, and manage chronic metabolic diseases such as Type 1 and Type 2 diabetes.

Historical and Clinical Context of Low-Carbohydrate Diets

Teicholz et al. (2025) emphasize that LCDs are not new but have been extensively studied for decades. Contrary to popular belief, carbohydrate reduction has a long history in medical practice. Before the discovery of insulin in 1921, LCDs were the standard treatment for diabetes. Historical records dating back to the early 20th century document their effectiveness in reducing hyperglycemia and stabilizing blood sugar levels in individuals with diabetes. Modern clinical trials reinforce these historical findings, demonstrating that LCDs provide significant benefits for weight management, blood sugar regulation, and cardiovascular health. Research has shown that LCDs outperform low-fat diets in improving glycemic control, lipid profiles, and reducing medication dependency in people with metabolic disorders.

How LCDs Work: A Shift in Metabolism

One of the primary mechanisms by which LCDs improve metabolic health is through a process called nutritional ketosis. When carbohydrate intake is restricted, the body shifts from using glucose as its primary energy source to burning fat for fuel. This metabolic state, known as ketosis, leads to the production of ketones, which serve as an alternative energy source for the brain, muscles, and organs.

This metabolic shift has profound implications for individuals with diabetes, as it reduces the need for large insulin doses, stabilizes blood sugar levels, and minimizes glucose fluctuations. By reducing reliance on carbohydrates, LCDs help improve insulin sensitivity, making them a valuable tool for managing both Type 1 and Type 2 diabetes.

Key Benefits of LCDs in Diabetes and Metabolic Health

Teicholz et al. (2025) highlight multiple health benefits associated with LCDs, particularly in individuals with diabetes:

✅ Improved Blood Sugar Control – LCDs lower postprandial glucose spikes, reducing the need for high insulin doses.
✅ Reduced Insulin Resistance – Lower carbohydrate intake helps improve insulin sensitivity, particularly in individuals with metabolic syndrome.
✅ Weight Management – LCDs promote satiety and reduce overall calorie intake, leading to sustainable weight loss.
✅ Lower Triglycerides and Increased HDL (Good) Cholesterol – LCDs have been shown to improve lipid profiles, reducing the risk of cardiovascular disease.
✅ Reduced Medication Dependence – Many individuals on LCDs reduce or eliminate their need for diabetes medications.

For individuals with Type 1 Diabetes (T1D), Therapeutic Carbohydrate Reduction (TCR) is a structured LCD approach used to achieve stable, normal blood glucose levels. This is particularly important for parents managing T1D in children, as tighter glycemic control reduces the risk of long-term complications such as neuropathy, retinopathy, and cardiovascular disease.

Addressing Common Concerns About Low-Carb Diets

Despite the extensive research supporting low-carbohydrate diets (LCDs), several concerns persist, often discouraging individuals, including those with Type 1 Diabetes (T1D), from adopting this dietary approach. The study by Teicholz et al. (2025) systematically addressed these concerns using clinical trial data, distinguishing fact from fiction.

1. Do Low-Carb Diets Cause Nutritional Deficiencies?

One of the primary concerns about LCDs is that they may lead to nutrient deficiencies due to the reduction in carbohydrate-containing foods, such as whole grains, fruits, and legumes.

Critics argue that such a dietary approach may lack essential vitamins, minerals, and fiber.

🔍 Key Findings:

• Clinical trial data confirm that well-structured LCDs provide adequate nutrition, including all essential vitamins and minerals.
• The quality of an LCD plays a crucial role in nutrient sufficiency, with emphasis placed on consuming whole, unprocessed foods such as:

o Meat, fish, poultry, and eggs (high in protein and essential nutrients)
o Dairy products (rich in calcium, vitamin D, and probiotics)
o Non-starchy vegetables (a key source of fiber, vitamins, and minerals)
o Nuts and seeds (providing healthy fats, magnesium, and fiber)

• The study highlighted that LCDs can provide sufficient micronutrients, including vitamin C, potassium, and magnesium, when food choices are optimized.

• The absence of dietary carbohydrates does not inherently cause nutrient deficiencies, as there are no essential carbohydrates required by the body.

📌 Implication for T1D:

For individuals managing T1D, maintaining adequate nutrition is essential for overall health. The study confirms that a well-balanced LCD does not inherently lead to nutrient deficiencies when planned properly, offering a viable dietary approach without compromising nutritional status.

Do Low-Carb Diets Increase the Risk of Heart Disease?

A longstanding myth about LCDs is that they contribute to heart disease due to their higher intake of saturated fats. Historically, dietary guidelines have discouraged high-fat intake, associating it with increased cardiovascular risk. However, Teicholz et al. (2025) reviewed substantial scientific evidence that contradicts this claim.

🔍 Key Findings:

• Saturated fat intake does not correlate with increased heart disease risk when carbohydrate intake is controlled.
• LCDs have been shown to improve several cardiovascular risk markers, including:

✅ Reduced triglycerides – Elevated triglycerides are a known risk factor for cardiovascular disease, and LCDs have been shown to significantly lower triglyceride levels.
✅ Increased HDL ("good") cholesterol – HDL cholesterol helps remove excess cholesterol from the bloodstream, reducing the risk of plaque buildup.
✅ Improved insulin sensitivity – Insulin resistance is a key driver of cardiovascular disease, and LCDs help improve insulin function.

• While LDL cholesterol (commonly referred to as "bad cholesterol") may increase in some individuals following an LCD, recent research suggests that this does not necessarily contribute to plaque formation or an increased risk of heart disease.

• The study noted that the most significant cardiovascular benefits of LCDs come from their ability to reduce metabolic dysfunction, which is a stronger predictor of heart disease than LDL cholesterol alone.

📌 Implication for T1D:

Individuals with T1D are already at a higher risk for cardiovascular disease. The findings from Teicholz et al. (2025) suggest that adopting an LCD and improving metabolic health through Therapeutic Carbohydrate Reduction (TCR) could be more beneficial for heart health than adhering to conventional high-carbohydrate dietary recommendations.

Do Low-Carb Diets Cause Kidney Damage?

Another commonly cited concern is that LCDs may contribute to kidney damage, particularly due to their moderate-to-high protein intake. Given that kidney disease is a known complication of diabetes, this concern is especially relevant for individuals with T1D.

🔍 Key Findings:

• LCDs are typically moderate in protein, not high, and do not cause kidney damage in individuals with normal kidney function.
• The study cites a systematic review that found no evidence linking LCDs to impaired kidney function.
• For individuals with early-stage kidney disease, the research suggests that reducing dietary carbohydrate intake while maintaining moderate protein consumption may help slow the progression of kidney disease.
• The biggest risk factor for kidney disease in diabetes is high blood sugar levels, not dietary protein intake. LCDs, by improving glycemic control, may actually help protect kidney function.

📌 Implication for T1D:

For individuals with T1D, maintaining stable blood glucose levels is the most critical factor in preventing diabetes-related kidney disease. The study supports the safety of LCDs, reinforcing that they do not contribute to kidney dysfunction when properly formulated.

Are Low-Carb Diets Difficult to Sustain?

Critics argue that LCDs are difficult to follow long-term, citing concerns about food variety, affordability, and adherence. However, the study challenges this assumption by reviewing long-term data on dietary adherence.

🔍 Key Findings:

• Long-term adherence to LCDs is comparable to other dietary patterns, including low-fat and Mediterranean diets.
• Satiety and blood sugar stability make LCDs easier to follow than conventional high-carbohydrate diets.
• LCDs promote greater satisfaction due to their emphasis on nutrient-dense, protein- and fat-rich foods, which help curb hunger and reduce cravings.
• Clinical trials show sustained weight loss and metabolic improvements in individuals adhering to LCDs for one year or longer.
• The study highlighted real-world adherence data, showing that many individuals successfully maintain LCDs long-term, even without direct clinical supervision.

📌 Implication for T1D:

For individuals with T1D, dietary consistency is critical for maintaining stable blood glucose levels. Given that LCDs support blood sugar stability and appetite regulation, they may actually be easier to sustain than conventional high-carb diets, particularly for those prioritizing metabolic control.

Evidence-Based Reassurance for T1D and LCDs

The findings from Teicholz et al. (2025) reinforce that low-carbohydrate diets are safe, effective, and nutritionally complete when structured appropriately. Many of the concerns traditionally associated with LCDs—nutritional deficiencies, heart disease, kidney damage, and sustainability—do not hold up under rigorous scientific scrutiny.

For individuals managing Type 1 Diabetes, Therapeutic Carbohydrate Reduction (TCR) offers a compelling dietary strategy to achieve stable, normal blood glucose levels, improve long-term metabolic health, and potentially reduce diabetes-related complications.

While individualization and clinical support are key, the study provides reassurance that LCDs are not only viable but also highly beneficial for those navigating T1D management.

Key Takeaways for the Type 1 Diabetes Community

For individuals and families navigating Type 1 Diabetes (T1D), the Teicholz et al. (2025) study provides much-needed clarity on the role of low-carbohydrate diets (LCDs) in diabetes management. By systematically addressing long-standing misconceptions, this study offers scientific reassurance that LCDs are safe, effective, and nutritionally adequate when properly structured.

The evidence presented in the study reinforces the idea that Therapeutic Carbohydrate Reduction (TCR) is a valuable dietary strategy for individuals with T1D who seek to achieve stable, normal blood glucose levels. Given the metabolic complexities of T1D, dietary choices play a crucial role in determining long-term health outcomes. The study’s findings provide a scientific foundation for why many individuals with T1D and their families opt for carbohydrate reduction to better manage the condition.

✅ What This Means for T1D Management:

The study's findings confirm several key insights that are particularly relevant to individuals with Type 1 Diabetes:

1️⃣ Carbohydrate Reduction is a Viable and Effective Strategy for Blood Sugar Control
The study affirms that reducing carbohydrate intake is one of the most effective methods for stabilizing blood glucose levels. By limiting carbohydrate consumption, individuals with T1D can minimize glucose variability, reduce post-meal spikes, and lower their overall insulin needs.

2️⃣ Low-Carb Diets Do Not Increase the Risk of Heart Disease
One of the biggest concerns about LCDs—that they may elevate cardiovascular risk due to increased fat intake—is not supported by scientific evidence. Instead, the study highlights that LCDs:

• Reduce triglycerides
• Increase HDL cholesterol
• Improve insulin sensitivity
• Show no conclusive link between dietary saturated fat intake and heart disease risk

For individuals with T1D, who already have a higher risk of cardiovascular complications, the findings suggest that improving metabolic health through carbohydrate reduction is more beneficial than following conventional high-carb dietary recommendations.

3️⃣ Low-Carb Diets Do Not Cause Nutritional Deficiencies
Contrary to common claims, well-structured LCDs provide all essential nutrients when designed correctly. The study confirms that LCDs can be nutrient-dense, focusing on whole, unprocessed foods rich in protein, healthy fats, non-starchy vegetables, and essential micronutrients such as vitamin C, potassium, and magnesium.

4️⃣ Low-Carb Diets Are Sustainable in the Long Term
A persistent myth is that LCDs are too restrictive and difficult to sustain over time. However, the study finds that:

• Adherence to LCDs is comparable to (or better than) other dietary approaches, including low-fat and Mediterranean diets.
• Satiety and blood sugar stability make LCDs easier to follow, as they reduce cravings and energy fluctuations.
• Clinical trials show long-term weight loss and metabolic benefits for individuals who adhere to LCDs for one year or longer. For individuals managing T1D, maintaining dietary consistency is essential for stable blood sugar control, making LCDs a sustainable choice.

📌 Final Thought: Why This Matters for the T1D Community

For parents of children with T1D, as well as adults managing their own diabetes, understanding the facts about low-carbohydrate nutrition is essential. The Teicholz et al. (2025) study provides scientific validation that TCR is not a fad diet, but a clinically supported intervention with measurable benefits for metabolic health.

The growing body of clinical trial data, real-world case studies, and increasing support from international diabetes organizations suggests that TCR should be recognized as a legitimate dietary option for individuals seeking improved glycemic control, reduced long-term complications, and a better quality of life.

While individualization and medical supervision remain important, the evidence overwhelmingly supports that low-carbohydrate diets are a safe, effective, and sustainable approach for managing T1D.

🚀 The Future of T1D Management

As scientific understanding continues to evolve, it is critical for individuals, families, and healthcare providers to remain informed about the latest research. The findings from Teicholz et al. (2025) should encourage a more open discussion about the role of Therapeutic Carbohydrate Reduction (TCR) in T1D care.

🔹 For individuals with T1D and their families: This study reinforces the viability of LCDs as a powerful tool for diabetes management.
🔹 For healthcare providers: Understanding the latest evidence enables more informed discussions about dietary interventions for T1D.
🔹 For the broader medical community: Continued research into low-carbohydrate diets will help refine guidelines and expand treatment options for T1D.

For those interested in exploring the full details of this study, the Teicholz et al. (2025) paper provides an in-depth, evidence-based analysis of low-carbohydrate diets and their role in metabolic health. Additionally, for individuals managing Type 1 Diabetes (T1D), the Society of Metabolic Health Practitioners (SMHP) Position Statement on Therapeutic Carbohydrate Reduction (TCR) and the Institute for Personalized Therapeutic Nutrition (IPTN) Guide – TCR for T1D serve as valuable resources for understanding how carbohydrate reduction can be effectively implemented.

🔗 Read the full study: https://www.mdpi.com/2072-6643/17/6/1047

🔗 SMHP Position Statement on Therapeutic Carbohydrate Reduction for Type 1 diabetes: https://journalofmetabolichealth.org/index.php/jmh/article/view/100/357

🔗 IPTN - Therapeutic Carbohydrate Reduction in Type 1 Diabetes: A Guide for Dietitians and Nutritionists: https://www.therapeuticnutrition.org/tcr-type-1-diabetes-guide

The bottom line? Empowered individuals make better health decisions.

The T1D community deserves access to accurate, science-backed information to make informed choices about their dietary approach. With the right knowledge and support, TCR can be a game-changer in the pursuit of optimal metabolic health.