| Summary: | Background Glycemic control is usually poor in patients with endogenous-insulin-deficient diabetes, while low-carbon diets (LCD) are beneficial for glycemic control among patients with diabetes. However, few studies on LCD in patients with endogenous-insulin-deficient diabetes have been reported. Objective To investigate the efficacy and safety of LCD for patients with endogenous-insulin-deficient diabetes. Methods A total of 80 patients with endogenous-insulin-deficient diabetes (fasting C-peptide≤0.5 ng/mL) who were hospitalized in Shanghai Eighth People's Hospital from August 2018 to August 2022 were selected as research subjects and divided into the control diet (CD) group with 55 cases and LCD group with 25 cases. The CD group and LCD group were matched by propensity score matching (PSM) in a 1∶1 ratio based on age and diabetes duration as matching indicators and caliper value as 0.3. The two groups of patients were compared in terms of glycemic control on the first day of hospitalization and at discharge, including average blood glucose, coefficient of variation (CV), percentages of time in range (TIR), time below range (TBR) and time above range (TAR); use of antidiabetic drugs, including the numbers and dosages of daily insulin injection and the types of oral antidiabetic agents; incidence of adverse events, including proportion of individuals who developed diabetic ketoacidosis (DKA) or hypoglycemia. Results After PSM, 22 patients were included in the CD group and LCD group, respectively. The percentages of CV〔 (26.03±7.61) % vs. (33.79±12.46) % 〕and TAR〔 (20.19±17.57) % vs. (30.43±15.74) %〕were lower in the LCD group than in the CD group (both P<0.05), the percentage of TIR〔 (77.79±17.36) % vs. (67.05±17.59) %〕 was higher in the LCD group than in the CD group (P<0.05). The numbers and dosages of daily insulin injection and the types of oral antidiabetic agents in the LCD group were significantly lower than those in the CD group (P<0.05). There was no significant difference in the incidence of adverse events (4 cases, 18.2% vs.5 cases, 22.7%) between the two groups during hospitalization (P=0.709) . Conclusion Compared to general diet, LCD is beneficial in reducing glucose variability, prolonging TIR, reducing the use of antidiabetic agents without increasing the risk of DKA or hypoglycemia for patients with endogenous-insulin-deficient diabetes.
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