Treatment of XXXX 2 @entity6 in childhood using a very-low-calorie diet.

@entity1 @entity6 @entity164 @entity413 @entity2449
OBJECTIVE: Pharmacologic agents currently approved for use in @entity1 with @entity164 2 @entity6 ( @entity2449 and insulin) are less than optimal for some @entity1 . We evaluated the use of a ketogenic, very-low-calorie diet (VLCD) in the treatment of @entity164 2 @entity6 . RESEARCH DESIGN AND METHODS: We conducted a chart review of 20 @entity1 (mean age 14.5 +/- 0.4 years) who consumed a ketogenic VLCD in the treatment of @entity164 2 @entity6 . Several response variables (BMI, blood pressure, HbA(1c), blood @entity413 , and treatment regimens) were examined before, during, and up to 2 years after the diet and compared with a matched @entity6 control group. RESULTS: Before starting the diet, 11 of 20 @entity1 were treated with insulin and 6 with @entity2449 . Mean daily blood @entity413 values fell from 8.9 +/- 1.1 to 5.5 +/- 0.38 mmol/l (P < 0.0001) in the first 3 days of the VLCD, allowing insulin and oral agents to be discontinued in all but one subject. BMI fell from 43.5 +/- 1.8 to 39.3 +/- 1.8 kg/m(2) (P < 0.0001) and HbA(1c) dropped from 8.8 +/- 0.6 to 7.4 +/- 0.6% (P < 0.005) as the diet was continued for a mean of 60 +/- 8 days (range 4-130 days), and none required resumption of antidiabetic medications. Sustained decreases in BMI and insulin requirements were observed in @entity1 remaining on the VLCD for at least 6 weeks when compared with those of the control group. CONCLUSIONS: The ketogenic VLCD is an effective short-term, and possibly long-term, therapy for pediatric @entity1 with @entity164 2 @entity6 . Blood @entity413 control and BMI improve, allowing the discontinuation of exogenous insulin and other antidiabetic agents. This diet, although strict, has potential as an alternative to pharmacologic therapies for this emerging subset of @entity6 individuals.
