student profile: Miss Jessica Turton


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Thesis work

Thesis title: Low-Carbohydrate Diets for Type 1 Diabetes Mellitus

Supervisors: Grant David BRINKWORTH, Kieron ROONEY , Helen PARKER

Thesis abstract:

Low-carbohydrate (LC) diets have gained popularity in recent years as an alternative method for the management of various chronic diseases. LC diets are defined according to the American Diabetes Association classifications of less than 130 g/day or 26% total energy intake (TEI) from carbohydrate. Standard practice guidelines for diabetes management (type 1 and type 2) generally promote consistency with the Australian Dietary Guidelines which recommend the consumption of 45 to 65% TEI from carbohydrate. This advice conflicts with recent systematic reviews which are in favour of LC diets for the management of type 2 diabetes, while the evidence for the dietary management of type 1 diabetes mellitus (T1D) remains inconclusive due to a lack of high-quality scientific trials. T1D is an autoimmune condition characterised by the destruction of pancreatic beta cells and absolute insulin deficiency. Affected individuals have impaired glucose metabolism and are prone to chronic complications from hyperglycaemia, and acute complications from hypoglycaemia and ketoacidosis. The standard treatment consists of daily injections of insulin and diet flexibility is encouraged. The strongest predictor of diabetes complications is glycaemic control and achieving a haemoglobin A1c (HbA1c) of <7.0% (53 mmol/L) is considered the primary target in diabetes management. However, data from T1D registries (2010-2013) across nineteen countries in Australasia, Europe and North America (n = 324,501) reported that 84% of patients exhibited HbA1c above this target. It appears that current therapies are lacking in effect and adjunctive strategies for achieving glycaemic control require consideration. The aim of this thesis is to explore the use of LC diets for the management of T1D. The specific objectives of this thesis are to; investigate the delivery effectiveness of LC diets that have been employed in type 2 diabetes management; investigate the safety and effect of LC diet protocols currently being used in the clinical practice management of T1D; develop a dietary protocol for LC diets that can inform researchers and practitioners engaged in diabetes management; and, determine whether significant differences in T1D management outcomes exist between a LC diet and a higher-carbohydrate comparator.

Selected publications

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Journals

  • Bero, L., Chartres, N., Diong, J., Fabbri, A., Ghersi, D., Lam, J., Lau, A., McDonald, S., Mintzes, B., Sutton, P., Turton, J., et al (2018). The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures. Systematic Reviews, 7(1), 1-11. [More Information]

2018

  • Bero, L., Chartres, N., Diong, J., Fabbri, A., Ghersi, D., Lam, J., Lau, A., McDonald, S., Mintzes, B., Sutton, P., Turton, J., et al (2018). The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures. Systematic Reviews, 7(1), 1-11. [More Information]

Note: This profile is for a student at the University of Sydney. Views presented here are not necessarily those of the University.