Abstract
This report concerns a 59-year-old female with severe motor and intellectual disabilities who was successfully treated with a mildly carbohydrate-restricted diet. Weight gain and the onset of type 2 diabetes had occurred despite a calorie-restricted diet. Her fasting and postprandial glucose levels were 140 mg/dl and >200 mg/dl, respectively, and mild hyperlipidemia was evident. Administration of anti-hyperglycemic drugs was contraindicated due to this patient's inability to communicate the onset of symptoms associated with a hypoglycemic event.Therefore, the amount of rice and bread she consumed was reduced, resulting in her daily carbohydrate intake being lowered from 145 g to 126 g. However, her total caloric intake increased from 900 kcal to 1000 kcal following an increased fat intake. After three months on the lower-carbohydrate diet, her serum glucose concentrations decreased to <120 mg/dl after fasting and were <150 mg/dl 2 hours after meals. Despite the increase in total calories and fat intake, the patient's body weight decreased and her serum lipid profile improved. No significant adverse reactions were observed during 18 months on this diet. A lower-carbohydrate diet is thought to also be effective for patients with severe motor and intellectual disabilities who are obese and have type 2 diabetes, although the long-term safety of the diet remains unclear.
