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Treatment of type 2 diabetes in childhood using a very-low-calorie diet

Steven M Willi1, Kelley Martin, Farrah M Datko

  • 1Department of Pediatrics, and General Clinical Research Center, Medical University of South Carolina, Charleston, South Carolina, USA. willis@musc.edu

Diabetes Care
|January 30, 2004
PubMed

Insights

A ketogenic very-low-calorie diet (VLCD) effectively treats type 2 diabetes in children, improving blood glucose and BMI. This dietary approach can eliminate the need for insulin and other antidiabetic medications.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Nutritional Science

Background:

  • Current pharmacologic treatments for pediatric type 2 diabetes (metformin, insulin) have limitations.
  • Type 2 diabetes is an emerging condition in the pediatric population.
  • Alternative therapeutic strategies are needed for managing pediatric type 2 diabetes.

Purpose of the Study:

  • To evaluate the efficacy of a ketogenic very-low-calorie diet (VLCD) for treating type 2 diabetes in children.
  • To assess the impact of VLCD on glycemic control, BMI, and medication requirements.
  • To compare VLCD outcomes with a matched diabetic control group.

Main Methods:

  • Chart review of 20 pediatric patients with type 2 diabetes undergoing a ketogenic VLCD.
  • Analysis of response variables including BMI, blood pressure, HbA1c, and blood glucose.
  • Comparison of pre-diet, during-diet, and up to 2-year post-diet data with a control group.

Main Results:

  • Mean daily blood glucose significantly decreased within 3 days of VLCD initiation (P < 0.0001).
  • BMI and HbA1c levels showed significant reductions (P < 0.0001 and P < 0.005, respectively).
  • Insulin and oral antidiabetic agents were discontinued in most patients, with sustained improvements observed.

Conclusions:

  • Ketogenic VLCD is an effective short-term and potentially long-term therapy for pediatric type 2 diabetes.
  • VLCD improves glycemic control and BMI, enabling discontinuation of antidiabetic medications.
  • This diet presents a viable alternative to pharmacologic therapies for this patient group.
Abstract

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