Detail
Článek
Článek online
FT
Medvik - BMČ
  • Je něco špatně v tomto záznamu ?

Dynamics of glucose concentration during the initiation of ketogenic diet treatment in children with refractory epilepsy: Results of continuous glucose monitoring

K. Brožová, J. Michalec, M. Brabec, P. Bořilová, P. Kohout, J. Brož

. 2023 ; 8 (3) : 1021-1027. [pub] 20230704

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc23016395

OBJECTIVE: The ketogenic diet (KD) is a diet low in carbohydrates and rich in fats which has long been used to treat refractory epilepsy. The metabolic changes related to the KD may increase the risk of hypoglycemia, especially during the first days. The study focused on the impact of KD initiation on glycemia in non-diabetic patients with refractory epilepsy. METHODS: The subjects were 10 pediatric patients (6 boys, mean age 6.1 ± 2.4 years), treated for intractable epilepsy. Blinded continuous glucose monitoring system (CGM) Dexcom G4 was used. Patients started on their regular diet in the first 36 hours of monitoring, followed by an increase in lipids intake and a gradual reduction of carbohydrates (relations 1:1; 2:1; 3:1; 3.5:1). We analyzed changes in glycemia during fat: nonfat ratio changes using a generalized linear model. RESULTS: The mean monitored time per person was 6 days, 10 hours and 44 minutes. The mean ± SD glycemia for the regular diet was 4.84 ± 0.20 mmol/L, for the carbohydrates/fat ratio of 1:1 it was 4.03 ± 0.16, for the ratio of 2:1 it was 3.57 ± 0.10, for the ratio 3:1 it was 3.39 ± 0.13 and for the final ratio of 3.5:1 it was 2.79 ± 0.06 mmol/L (P < 0.001). The portions of time spent in glycemia ≤3.5 mmol/L (≤2.5 mmol/L respectively) were: on the normal diet 0.88% (0.31%) of the monitored period, during 1:1 KD ratio 1.92% (0.95%), during 2:1 ratio 3.18% (1.02%), and during 3:1 and 3.5:1 ratios 13.64% (2.36%) of the monitored time (P < 0.05). SIGNIFICANCE: Continuous glucose monitoring system shows the dynamic of glucose concentration in ketogenic diet treatment initiation. It may be a useful tool to control the effects of this diet on glucose metabolism, especially in hypoglycemia detection.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc23016395
003      
CZ-PrNML
005      
20231026105926.0
007      
ta
008      
231013s2023 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1002/epi4.12778 $2 doi
035    __
$a (PubMed)37345572
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Brožová, Klára $u Department of Pediatric Neurology, Thomayer University Hospital, Prague, Czech Republic $u Third Medical Faculty, Charles University, Prague, Czech Republic $1 https://orcid.org/0000000349585858
245    10
$a Dynamics of glucose concentration during the initiation of ketogenic diet treatment in children with refractory epilepsy: Results of continuous glucose monitoring / $c K. Brožová, J. Michalec, M. Brabec, P. Bořilová, P. Kohout, J. Brož
520    9_
$a OBJECTIVE: The ketogenic diet (KD) is a diet low in carbohydrates and rich in fats which has long been used to treat refractory epilepsy. The metabolic changes related to the KD may increase the risk of hypoglycemia, especially during the first days. The study focused on the impact of KD initiation on glycemia in non-diabetic patients with refractory epilepsy. METHODS: The subjects were 10 pediatric patients (6 boys, mean age 6.1 ± 2.4 years), treated for intractable epilepsy. Blinded continuous glucose monitoring system (CGM) Dexcom G4 was used. Patients started on their regular diet in the first 36 hours of monitoring, followed by an increase in lipids intake and a gradual reduction of carbohydrates (relations 1:1; 2:1; 3:1; 3.5:1). We analyzed changes in glycemia during fat: nonfat ratio changes using a generalized linear model. RESULTS: The mean monitored time per person was 6 days, 10 hours and 44 minutes. The mean ± SD glycemia for the regular diet was 4.84 ± 0.20 mmol/L, for the carbohydrates/fat ratio of 1:1 it was 4.03 ± 0.16, for the ratio of 2:1 it was 3.57 ± 0.10, for the ratio 3:1 it was 3.39 ± 0.13 and for the final ratio of 3.5:1 it was 2.79 ± 0.06 mmol/L (P < 0.001). The portions of time spent in glycemia ≤3.5 mmol/L (≤2.5 mmol/L respectively) were: on the normal diet 0.88% (0.31%) of the monitored period, during 1:1 KD ratio 1.92% (0.95%), during 2:1 ratio 3.18% (1.02%), and during 3:1 and 3.5:1 ratios 13.64% (2.36%) of the monitored time (P < 0.05). SIGNIFICANCE: Continuous glucose monitoring system shows the dynamic of glucose concentration in ketogenic diet treatment initiation. It may be a useful tool to control the effects of this diet on glucose metabolism, especially in hypoglycemia detection.
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé $7 D006801
650    _2
$a dítě $7 D002648
650    _2
$a předškolní dítě $7 D002675
650    12
$a ketogenní dieta $x metody $7 D055423
650    12
$a refrakterní epilepsie $7 D000069279
650    _2
$a krevní glukóza $7 D001786
650    _2
$a selfmonitoring glykemie $7 D015190
650    _2
$a dietní tuky $x metabolismus $7 D004041
650    _2
$a prospektivní studie $7 D011446
650    12
$a hypoglykemie $7 D007003
655    _2
$a časopisecké články $7 D016428
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Michalec, Juraj $u Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic $1 https://orcid.org/0009000654843742
700    1_
$a Brabec, Marek $u Institute of Computer Science, Academy of Science of the Czech Republic, Prague, Czech Republic $1 https://orcid.org/0000000163675791
700    1_
$a Bořilová, Petra $u Department of Pediatric Neurology, Thomayer University Hospital, Prague, Czech Republic $1 https://orcid.org/0000000323713858
700    1_
$a Kohout, Pavel $u Department of Internal Medicine, Third Faculty of Medicine Charles University and Thomayer University Hospital, Prague, Czech Republic $u Center of Nutrition, Thomayer University Hospital, Prague, Czech Republic $1 https://orcid.org/0000000239577005
700    1_
$a Brož, Jan $u Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic $1 https://orcid.org/0000000324657333 $7 xx0046397
773    0_
$w MED00197247 $t Epilepsia open $x 2470-9239 $g Roč. 8, č. 3 (2023), s. 1021-1027
856    41
$u https://pubmed.ncbi.nlm.nih.gov/37345572 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20231013 $b ABA008
991    __
$a 20231026105920 $b ABA008
999    __
$a ok $b bmc $g 2000108 $s 1202757
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2023 $b 8 $c 3 $d 1021-1027 $e 20230704 $i 2470-9239 $m Epilepsia open $n Epilepsia Open $x MED00197247
LZP    __
$a Pubmed-20231013

Najít záznam

Citační ukazatele

Možnosti archivace