{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:49:32Z","timestamp":1781596172010,"version":"3.54.5"},"reference-count":23,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The aim of this study was to evaluate the association between macronutrient intake and time in range (TIR) of 70\u2013180 mg\/dL in children and adolescents with type 1 diabetes (T1D). A multi-center study recruited patients with T1D using continuous glucose monitoring (CGM) between January 2019 and January 2020 from centers across Italy. Diet intake was recorded using three-day weighed food diaries. Nutrients were evaluated as percentages of total intake. TIR was considered at target if the percentage of readings was higher than 70%. Clinical and nutritional factors associated with TIR at target were analyzed using multiple correspondence analysis and multiple logistic regression. Data from 197 participants (53% male, median age 11.6 years, median HbA1c 55.2 mmol\/mol, median TIR 60%) were analyzed. Macronutrient intake was 45.9% carbohydrates, 16.9% protein, 37.3% fat, and 13.1 g\/day fiber (median values). TIR &gt; 70% was observed in 28% of participants; their diet contained more protein (17.6%, p = 0.015) and fiber (14.4 g\/day, p = 0.031) than those not at target. The probability of having a TIR &gt; 70% was significantly higher with 40\u201344% consumption of carbohydrates compared with 45\u201350% consumption of carbohydrates and with the use of a carbohydrate counting system. Based on these results, a five percent reduction in the percentage of carbohydrate intake can help children and adolescents with T1D achieve the goal of a TIR &gt; 70%. Both a lower and higher percentage of carbohydrate intake appears to reduce the probability of reaching the target TIR &gt; 70%. These results require validation in other populations before being used in clinical practice.<\/jats:p>","DOI":"10.3390\/nu13113869","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T22:24:22Z","timestamp":1635805462000},"page":"3869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Rethinking Carbohydrate Intake and Time in Range in Children and Adolescents with Type 1 Diabetes"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7664-1475","authenticated-orcid":false,"given":"Valentino","family":"Cherubini","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, G. Salesi Hospital, 60123 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4356-1070","authenticated-orcid":false,"given":"Monica","family":"Marino","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3232-8807","authenticated-orcid":false,"given":"Marco","family":"Marigliano","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-4404","authenticated-orcid":false,"given":"Claudio","family":"Maffeis","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Zanfardino","sequence":"additional","affiliation":[{"name":"Regional Center of Pediatric Diabetology, University of Campania \u201cL. Vanvitelli\u201d, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Rabbone","sequence":"additional","affiliation":[{"name":"Department of Health and Science, University of Oriental Piedmont, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Giorda","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, University of Turin, 10092 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Schiaffini","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Pediatric Hospital Bambino Ges\u00f9, 00031 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Lorubbio","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Pediatric Hospital Bambino Ges\u00f9, 00031 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Rollato","sequence":"additional","affiliation":[{"name":"Regional Center of Pediatric Diabetology, University of Campania \u201cL. Vanvitelli\u201d, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Iannilli","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, G. Salesi Hospital, 60123 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Iafusco","sequence":"additional","affiliation":[{"name":"Regional Center of Pediatric Diabetology, University of Campania \u201cL. Vanvitelli\u201d, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1518-8515","authenticated-orcid":false,"given":"Andrea E.","family":"Scaramuzza","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Pediatric Diabetes, Endocrinology and Nutrition, ASST Cremona, 26100 Cremona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Bowers","sequence":"additional","affiliation":[{"name":"Population Health, Faculty of Health Sciences, University of Ottawa, 64 Sherbrooke Avenue, Ottawa, ON 61350, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaria","family":"Gesuita","sequence":"additional","affiliation":[{"name":"Center of Epidemiology and Biostatistics, Polytechnic University of Marche, 60123 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/pedi.12738","article-title":"ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional Management in Children and Adolescents with Diabetes","volume":"19","author":"Smart","year":"2018","journal-title":"Pediatr. 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