Advanced cardiovascular physiology in an individual with type 1 diabetes after 10-year ketogenic diet.
Am J Physiol Cell Physiol
; 327(2): C446-C461, 2024 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-38912731
ABSTRACT
Adults with type 1 diabetes (T1D) have an elevated risk for cardiovascular disease (CVD) compared with the general population. HbA1c is the primary modifiable risk factor for CVD in T1D. Fewer than 1% of patients achieve euglycemia (<5.7% HbA1c). Ketogenic diets (KD; ≤50 g carbohydrate/day) may improve glycemia and downstream vascular dysfunction in T1D by reducing HbA1c and insulin load. However, there are concerns regarding the long-term CVD risk from a KD. Therefore, we compared data collected in a 60-day window in an adult with T1D on exogenous insulin who consumed a KD for 10 years versus normative values in those with T1D (T1D norms). The participant achieved euglycemia with an HbA1c of 5.5%, mean glucose of 98 [5] mg/dL (median [interquartile range]), 90 [11]% time-in-range 70-180 mg/dL (T1D norms 1st percentile for all), and low insulin requirements of 0.38 ± 0.03 IU/kg/day (T1D norms 8th percentile). Seated systolic blood pressure (SBP) was 113 mmHg (T1D norms 18th percentile), while ambulatory awake SBP was 132 ± 15 mmHg (T1D target <130 mmHg), blood triglycerides were 69 mg/dL (T1D norms 34th percentile), low-density lipoprotein was 129 mg/dL (T1D norms 60th percentile), heart rate was 56 beats/min (T1D norms >1SD below the mean), carotid-femoral pulse wave velocity was 7.17 m/s (T1D norms lowest quartile of risk), flow-mediated dilation was 12.8% (T1D norms >1SD above mean), and cardiac vagal baroreflex gain was 23.5 ms/mmHg (T1D norms >1SD above mean). Finally, there was no indication of left ventricular diastolic dysfunction from echocardiography. Overall, these data demonstrate below-average CVD risk relative to T1D norms despite concerns regarding the long-term impact of a KD on CVD risk.NEW & NOTEWORTHY Adults with type 1 diabetes (T1D) have a 10-fold higher risk for cardiovascular disease (CVD) compared with the general population. We assessed cardiovascular health metrics in an adult with T1D who presented with a euglycemic HbA1c after following a ketogenic diet for the past 10 years. Despite concerns about the ketogenic diet increasing CVD risk, the participant exhibited below-average CVD risk relative to others with T1D when considering all outcomes together.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Glicemia
/
Doenças Cardiovasculares
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Diabetes Mellitus Tipo 1
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Dieta Cetogênica
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Am J Physiol Cell Physiol
/
Am. j. physiol. cell physiol
/
American journal of physiology. Cell physiology
Assunto da revista:
FISIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos