{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:12:59Z","timestamp":1781093579379,"version":"3.54.1"},"reference-count":26,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Current guidelines for exercise-related glucose management focus on reducing bolus and\/or basal insulin doses and considering carbohydrate intake. Yet far less attention has been paid to the potential role of other macronutrients alongside carbohydrates on glucose dynamics around exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate the effects of a low-carbohydrate-high-protein (LCHP) compared with a high-carbohydrate-low-protein (HCLP) pre-exercise meal on the metabolic, hormonal, and physiological responses to exercise in adults with insulin pump\u2013treated type 1 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Fourteen adults (11 women, 3 men) with insulin pump\u2013treated type 1 diabetes (median [range] HbA1c of 50 [43-59] mmol\/mol (6.7% [6.1%-7.5%]), age of 49 [25-65] years, and body mass index of 24.0 [19.3-27.1] kg\/m2) completed an unblinded, 2-arm, randomized, crossover study. Participants ingested isocaloric meals that were either LCHP (carbohydrate 21%, protein 52%, fat 27%) or HCLP (carbohydrate 52%, protein 21%, fat 27%) 90 minutes prior to undertaking 45 minutes of cycling at moderate intensity. Meal insulin bolus was dosed according to meal carbohydrate content but reduced by 25%. Basal insulin rates were reduced by 35% from meal ingestion to end of exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Around exercise the coefficient of variability was lower during LCHP (LCHP: 14.5 \u00b1 5.3 vs HCLP: 24.9 \u00b1 7.7%, P = .001). Over exercise, LCHP was associated with a lesser drop (LCHP: \u0394\u22121.49 \u00b1 1.89 vs HCLP: \u0394\u22123.78 \u00b1 1.95 mmol\/L, P = .001). Mean insulin concentration was 30% lower during exercise for LCHP compared with HCLP (LCHP: 25.5 \u00b1 11.0 vs HCLP: 36.5 \u00b1 15.9 mU\/L, P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Ingesting a LCHP pre-exercise meal lowered plasma glucose variability around exercise and diminished the drop in plasma glucose over exercise.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad427","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T20:59:42Z","timestamp":1689713982000},"page":"208-216","source":"Crossref","is-referenced-by-count":10,"title":["Effects of a Low-Carbohydrate-High-Protein Pre-Exercise Meal in Type 1 Diabetes\u2014a Randomized Crossover Trial"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8614-6729","authenticated-orcid":false,"given":"Kasper B","family":"Kristensen","sequence":"first","affiliation":[{"name":"Copenhagen University Hospital\u2014Steno Diabetes Center Copenhagen , 2730 Herlev , Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , 2200 Copenhagen N , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2253-6071","authenticated-orcid":false,"given":"Ajenthen G","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital\u2014Steno Diabetes Center Copenhagen , 2730 Herlev , Denmark"},{"name":"Danish Diabetes Academy , 5000 Odense C , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6971-611X","authenticated-orcid":false,"given":"Olivia M","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital\u2014Steno Diabetes Center Copenhagen , 2730 Herlev , 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