ESPE Abstracts

Objectives: Given the critical role of linear growth and peak bone mass attainment in childhood and adolescence, this study sought to elucidate the effects of a low carbohydrate diet (LCD) versus a Mediterranean diet (MED) on bone turnover markers (BTM) in adolescents with type 1 diabetes (T1D).

Methods: In an open-label, randomized controlled trial, 40 individuals with type 1 diabetes, aged 12-22 years, were randomly assigned to either the LCD or MED for a 24-week intervention period. Baseline levels of C-terminal telopeptide (CTX) and procollagen type 1 N-terminal propeptide (P1NP) were measured before dietary intervention and compared with post-intervention levels. Glycemic and nutritional parameters were evaluated as well.

Results: Baseline characteristics were similar between the LCD and MED groups. While changes in dietary calcium (P = 0.035), magnesium (P = 0.001), and potassium (P = 0.05) were significantly lower in the LCD group compared to the MED group after the 6-month intervention, BTM did not show significant changes. The median CTX levels increased from 395 pg/ml (232-591) to 423 pg/ml (289-591) in the LCD group and decreased from 357 pg/ml (244-782) to 296 pg/ml (227-661) in the MED group. Median P1NP levels changed from 95 ng/ml (68-112) to 88 ng/ml (62-97) in the LCD group and from 76 ng/ml (54-198) to 71 ng/ml (55-122) in the MED group, with no significant changes observed. Median daily carbohydrate intake was 60g (45;88) for the LCD group and 128g (104;155) for the MED group. The delta BMI z-score was lower in the LCD compared to the MED group P = 0.08.

Conclusion: The 6-month dietary intervention with LCD or MED did not significantly alter bone turnover markers in adolescents with T1D. Longer-term studies are needed to fully assess the impact of dietary patterns on BTM in this population. Extended research with personalized interventions is crucial for optimizing bone health and reducing osteoporosis risk in T1D adolescents.