{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:55:26Z","timestamp":1792158926770,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/Introduction<\/jats:title>\n                    <jats:p>The effects of lifestyle factors on macrovascular events or all\u2010cause mortality remain unclear in type 1 diabetes. We examined the associations of diet, physical activity, and sleep with these outcomes among adults with type 1 diabetes living in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This multicenter prospective cohort included 352 adults with type 1 diabetes from the Juntendo\u2013Aso Type 1 Diabetes cohort. Lifestyle factors were assessed by questionnaire. Dietary intake was evaluated using a brief\u2010type self\u2010administered diet history questionnaire, from which Total, Plant, and Animal low\u2010carbohydrate diet scores were calculated. The primary composite outcome was the first occurrence of ischemic heart disease, cerebrovascular disease, peripheral artery disease, or all\u2010cause mortality. Associations were analyzed using Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 51.4\u2009\u00b1\u200915.1\u2009years, mean HbA1c was 7.9\u2009\u00b1\u20091.1%, and carbohydrate accounted for 49.3% of energy intake. During follow\u2010up, 35 participants experienced the primary composite outcome. In multivariable Cox models, the Total LCDS (HR, 0.90; 95% CI: 0.82\u20130.98;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.012), Plant LCDS (HR, 0.85; 95% CI: 0.76\u20130.94;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003), and Animal LCDS (HR, 0.93; 95% CI: 0.87\u20130.996;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.037) were inversely associated with the outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among adults with type 1 diabetes living in Japan, low\u2010carbohydrate dietary patterns, particularly the Plant low\u2010carbohydrate diet score, were inversely associated with macrovascular events or all\u2010cause mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70468","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:28:50Z","timestamp":1792157330000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between low\u2010carbohydrate diet scores and macrovascular events or all\u2010cause mortality in adults with type 1 diabetes in Japan"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9784-5362","authenticated-orcid":false,"given":"Junko","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4401-2965","authenticated-orcid":false,"given":"Tomoya","family":"Mita","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Negami","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Fujikawa","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4306-8809","authenticated-orcid":false,"given":"Eri","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8396-423X","authenticated-orcid":false,"given":"Yuya","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7638-6056","authenticated-orcid":false,"given":"Fuki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsumi","family":"Aso","sequence":"additional","affiliation":[{"name":"Aso Clinic  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-1816","authenticated-orcid":false,"given":"Hirotaka","family":"Watada","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Endocrinology Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S0140-6736(18)31506-X","article-title":"Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: A nationwide, register\u2010based cohort study","volume":"392","author":"Rawshani A","year":"2018","journal-title":"Lancet"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"2843","DOI":"10.2337\/dc14-1720","article-title":"Type 1 diabetes mellitus and cardiovascular disease: A 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