The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes
This article presents the position of the Society of Metabolic Health Practitioners (SMHP) regarding therapeutic carbohydrate reduction (TCR) nutrition interventions for type 1 diabetes mellitus (T1DM). A modified Delphi methodology was used to arrive at a consensus consisting of several focus group...
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2024-11-01
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| Series: | Journal of Metabolic Health |
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| Online Access: | https://journalofmetabolichealth.org/index.php/jmh/article/view/100 |
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| author | Tro Kalayjian Beth J. McNally Matthew W. Calkins Mark T. Cucuzzella Robert Cywes Hayden Dikeman David T. Dikeman Evelyne Bourdua-Roy Sarah M. Rice Ian Lake Laura A. Buchanan Douglas B. Reynolds Mirian Kalamian Eric C. Westman |
| author_facet | Tro Kalayjian Beth J. McNally Matthew W. Calkins Mark T. Cucuzzella Robert Cywes Hayden Dikeman David T. Dikeman Evelyne Bourdua-Roy Sarah M. Rice Ian Lake Laura A. Buchanan Douglas B. Reynolds Mirian Kalamian Eric C. Westman |
| author_sort | Tro Kalayjian |
| collection | DOAJ |
| description | This article presents the position of the Society of Metabolic Health Practitioners (SMHP) regarding therapeutic carbohydrate reduction (TCR) nutrition interventions for type 1 diabetes mellitus (T1DM). A modified Delphi methodology was used to arrive at a consensus consisting of several focus groups, multiple rounds, and an anonymous survey. The field of endocrinology has seen many new advances for the treatment of T1DM including hybrid closed-loop insulin delivery systems and continuous glucose monitors for better glycaemic control, monoclonal antibodies to delay the onset of disease and increased access to paediatric endocrinologists, among many other noteworthy achievements. Despite these advancements, standard of care approaches to T1DM result in higher than acceptable morbidity and mortality, with a high prevalence of microvascular and macrovascular complications. Insulin resistance in type 1 diabetes is an independent risk factor for adverse outcomes even in well controlled type 1 diabetes. In 2021, only 21% of adults with T1DM in the United States achieved the American Diabetes Association’s (ADA’s) target haemoglobin A1C goal of 7.0%, while data in the paediatric and adolescent population have demonstrated worse glycaemic control. Supported by observational and interventional evidence, the SMHP advocates for the reevaluation of the prevailing nutritional therapy for T1DM with more broad consideration for TCR. The SMHP recommends open access and clinical support for TCR nutrition interventions for individuals with T1DM of all ages and calls upon the medical community to help foster more attention and research on TCR for T1DM. |
| format | Article |
| id | doaj-art-fa58221e4e6b43619e2d0798bfcca016 |
| institution | DOAJ |
| issn | 2960-0391 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Journal of Metabolic Health |
| spelling | doaj-art-fa58221e4e6b43619e2d0798bfcca0162025-08-20T02:50:40ZengAOSISJournal of Metabolic Health2960-03912024-11-0171e1e910.4102/jmh.v7i1.10055The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetesTro Kalayjian0Beth J. McNally1Matthew W. Calkins2Mark T. Cucuzzella3Robert Cywes4Hayden Dikeman5David T. Dikeman6Evelyne Bourdua-Roy7Sarah M. Rice8Ian Lake9Laura A. Buchanan10Douglas B. Reynolds11Mirian Kalamian12Eric C. Westman13Department of Medicine, Greenwich Hospital/Yale New Haven Health, Greenwich, ConnecticutPrivate Practice Nutritionist, Kingston, OntarioDepartment of Family Medicine, Atrium One Health, Rural HallDepartment of Family Medicine, West Virginia University, Morgantown, West VirginiaPrivate Practice Doctor, Jupiter, FloridaDepartment of Biology, Emory University, Atlanta, GeorgiaDepartment of Biology, Baylor University, Waco, TexasPrivate Practice Doctor, QuebecPrivate Research and editing, Cape Town,Private Practice Doctor, GloucesterDepartment of Telemedicine, Toward Health, Tappan, New York StateSociety of Metabolic Health Practitioners, San Diego, CaliforniaPrivate Practice Nutritionist, Hamilton, MontanaDepartment of Medicine, Duke University Health System, Durham, North CarolinaThis article presents the position of the Society of Metabolic Health Practitioners (SMHP) regarding therapeutic carbohydrate reduction (TCR) nutrition interventions for type 1 diabetes mellitus (T1DM). A modified Delphi methodology was used to arrive at a consensus consisting of several focus groups, multiple rounds, and an anonymous survey. The field of endocrinology has seen many new advances for the treatment of T1DM including hybrid closed-loop insulin delivery systems and continuous glucose monitors for better glycaemic control, monoclonal antibodies to delay the onset of disease and increased access to paediatric endocrinologists, among many other noteworthy achievements. Despite these advancements, standard of care approaches to T1DM result in higher than acceptable morbidity and mortality, with a high prevalence of microvascular and macrovascular complications. Insulin resistance in type 1 diabetes is an independent risk factor for adverse outcomes even in well controlled type 1 diabetes. In 2021, only 21% of adults with T1DM in the United States achieved the American Diabetes Association’s (ADA’s) target haemoglobin A1C goal of 7.0%, while data in the paediatric and adolescent population have demonstrated worse glycaemic control. Supported by observational and interventional evidence, the SMHP advocates for the reevaluation of the prevailing nutritional therapy for T1DM with more broad consideration for TCR. The SMHP recommends open access and clinical support for TCR nutrition interventions for individuals with T1DM of all ages and calls upon the medical community to help foster more attention and research on TCR for T1DM.https://journalofmetabolichealth.org/index.php/jmh/article/view/100type 1 diabetes mellitustherapeutic carbohydrate reductionlow-carbohydrate dietketogenic dietvery low-carbohydrate dietglycaemic controldouble diabetesinsulin resistance. |
| spellingShingle | Tro Kalayjian Beth J. McNally Matthew W. Calkins Mark T. Cucuzzella Robert Cywes Hayden Dikeman David T. Dikeman Evelyne Bourdua-Roy Sarah M. Rice Ian Lake Laura A. Buchanan Douglas B. Reynolds Mirian Kalamian Eric C. Westman The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes Journal of Metabolic Health type 1 diabetes mellitus therapeutic carbohydrate reduction low-carbohydrate diet ketogenic diet very low-carbohydrate diet glycaemic control double diabetes insulin resistance. |
| title | The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes |
| title_full | The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes |
| title_fullStr | The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes |
| title_full_unstemmed | The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes |
| title_short | The SMHP™ position statement on therapeutic carbohydrate reduction for type 1 diabetes |
| title_sort | smhp™ position statement on therapeutic carbohydrate reduction for type 1 diabetes |
| topic | type 1 diabetes mellitus therapeutic carbohydrate reduction low-carbohydrate diet ketogenic diet very low-carbohydrate diet glycaemic control double diabetes insulin resistance. |
| url | https://journalofmetabolichealth.org/index.php/jmh/article/view/100 |
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