{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:12:21Z","timestamp":1792145541900,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To review the spectrum of meal\u2010management strategies currently used with automated insulin delivery (AID) systems, combining published evidence with contemporary clinical experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This narrative review examined published approaches to prandial management with AID and incorporated the experience of ten French diabetes specialists from high\u2010volume adult and pediatric AID centers. Strategies were categorized according to the degree of carbohydrate estimation, user involvement, and cognitive burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Although accurate carbohydrate counting remains the reference approach, experts described a continuum of increasingly simplified strategies, including semi\u2010quantitative meal announcements, fixed repetitive meal announcements, insulin\u2010driven announcements based on the intended insulin dose, and proxy announcements using fictitious carbohydrate entries primarily to signal meal initiation. Semi\u2010quantitative approaches currently have the strongest evidence base and may provide an effective alternative to precise carbohydrate counting, whereas several other strategies used in routine practice remain largely unevaluated prospectively. Despite their differences, these approaches share the objective of preserving timely prandial insulin delivery and, whenever possible, bolus\u2010calculator use while reducing educational requirements and cognitive burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Meal management with AID should be individualized according to patient abilities, preferences, eating patterns, treatment burden, and system characteristics rather than viewed as a binary choice between precise carbohydrate counting and no meal announcement. As optional\u2010announcement hybrid closed\u2010loop and fully closed\u2010loop technologies emerge, the required level of user involvement may progressively decrease, further shifting meal management toward simpler and more autonomous approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71369","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:05:22Z","timestamp":1789617922000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rethinking Meal Management in Automated Insulin Delivery: From Carbohydrate Counting to Simplified Approaches"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8731-7355","authenticated-orcid":false,"given":"Michael","family":"Joubert","sequence":"first","affiliation":[{"name":"Diabetes Care Unit CHU Caen, UNICAEN  Caen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chlo\u00e9","family":"Amouyal","sequence":"additional","affiliation":[{"name":"Diabetology Department, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital, INSERM Nutriomic Team Sorbonne Universit\u00e9, AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Bismuth","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology and Diabetology, Robert\u2010Debr\u00e9 Hospital, Assistance Publique H\u00f4pitaux de Paris University of Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Borot","sequence":"additional","affiliation":[{"name":"SINERGIES, Service D'endocrinologie, Diab\u00e9tologie, Nutrition Universit\u00e9 Marie et Louis Pasteur, CHU Besan\u00e7on  Besan\u00e7on 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