Low-Carbohydrate Diet Impairs the Effect of Glucagon in the Treatment of Insulin-Induced Mild Hypoglycemia: A Randomized Crossover Study.
Study Goal
The researchers aimed to compare the effectiveness of glucagon in restoring plasma glucose after mild hypoglycemia in patients with type 1 diabetes on a high-carbohydrate diet versus a low-carbohydrate diet.
Results Summary
The low-carbohydrate diet resulted in significantly lower incremental rises in plasma glucose after glucagon administration compared to the high-carbohydrate diet. No differences were observed in insulin, glucagon, or triglyceride concentrations between the diets.
Population
Ten patients with insulin pump-treated type 1 diabetes.
Effective Dosage
≤50 g/day for the low-carbohydrate diet.
Duration
1 week per diet.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low-carbohydrate diet (LCD) | decrease | plasma glucose (PG) after the first glucagon bolus | patients with insulin pump-treated type 1 diabetes | 1.3 ± 0.3 vs. 2.7 ± 0.4 mmol/L | resulted in lower incremental rises | #1 |
low-carbohydrate diet (LCD) | decrease | plasma glucose (PG) after the second glucagon bolus | patients with insulin pump-treated type 1 diabetes | 4.1 ± 0.2 vs. 5.6 ± 0.5 mmol/L | resulted in lower incremental rises | #2 |
low-carbohydrate diet (LCD) | no change | concentrations of insulin | patients with insulin pump-treated type 1 diabetes | - | No differences were observed | #3 |
low-carbohydrate diet (LCD) | no change | concentrations of glucagon | patients with insulin pump-treated type 1 diabetes | - | No differences were observed | #4 |
low-carbohydrate diet (LCD) | no change | concentrations of triglycerides | patients with insulin pump-treated type 1 diabetes | - | No differences were observed | #5 |
low-carbohydrate diet (LCD) | decrease | glucagon on mild hypoglycemia | patients with type 1 diabetes | - | reduces the treatment effect | #6 |
OBJECTIVE: This study compared the ability of glucagon to restore plasma glucose (PG) after mild hypoglycemia in patients with type 1 diabetes on an isocaloric high-carbohydrate diet (HCD) versus a low-carbohydrate diet (LCD). RESEARCH DESIGN AND METHODS: Ten patients with insulin pump-treated type 1 diabetes randomly completed 1 week of the HCD (≥250 g/day) and 1 week of the LCD (≤50 g/day). After each week, mild hypoglycemia was induced by a subcutaneous insulin bolus in the fasting state. When PG reached 3.9 mmol/L, 100 µg glucagon was given subcutaneously, followed by 500 µg glucagon 2 h later. RESULTS: Compared with the HCD, the LCD resulted in lower incremental rises in PG after the first (mean ± SEM: 1.3 ± 0.3 vs. 2.7 ± 0.4 mmol/L, P = 0.002) and second glucagon bolus (4.1 ± 0.2 vs. 5.6 ± 0.5 mmol/L, P = 0.002). No differences were observed between the diets regarding concentrations of insulin, glucagon, and triglycerides. CONCLUSIONS: The LCD reduces the treatment effect of glucagon on mild hypoglycemia. Carbohydrate intake should be considered when low-dose glucagon is used to correct hypoglycemia.