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Prolonging Partial Remission in Type 1 Diabetes: The Role of Low-Carbohydrate Diet: A Literature Review

Rittweger de Moor M, Gdoura M, Lysy PA

Diabetes, metabolic syndrome and obesity : targets and therapy, 2026

Abstract

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by progressive destruction of insulin-producing β-cells, resulting in lifelong insulin dependence and impaired quality of life. Although a transient phase of partial remission may occur after diagnosis, sustained preservation of β-cell function remains exceptional. Recently, low-carbohydrate diets (LCD) have gained attention among patients, partly driven by anecdotal reports describing prolonged remission.

Objective: The aim of this review was to critically examine the existing clinical evidence for prolonged partial remission under LCD in patients with T1DM and to summarize the biological mechanisms proposed in the literature to explain such observations.

Methods: A literature review was conducted focusing on reports of prolonged remission in individuals with T1DM adopting an LCD, as well as experimental studies exploring mechanistic pathways potentially modulated by carbohydrate restriction.

Results: Only six individual cases describing prolonged partial remission under LCD were identified in the literature. The diagnostic certainty of T1DM in these reports was variable, and misclassification (eg, latent autoimmune diabetes in adults or monogenic diabetes) cannot be excluded. The mechanistic hypotheses proposed-including reduction of glucotoxicity, modulation of inflammation, attenuation of oxidative stress, and possible β-cell regeneration-are derived predominantly from animal models, in…

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