{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:56:25Z","timestamp":1791928585536,"version":"4.3.4"},"reference-count":105,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"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>Achieving optimal glucose control in individuals with type 1 diabetes (T1DM) continues to pose a significant challenge. While continuous insulin infusion systems have shown promise as an alternative to conventional insulin therapy, there remains a crucial need for greater awareness regarding the necessary adaptations for various special circumstances. Nutritional choices play an essential role in the efficacy of diabetes management and overall health status for patients with T1DM. Factors such as effective carbohydrate counting, assessment of the macronutrient composition of meals, and comprehending the concept of the glycemic index of foods are paramount in making informed pre-meal adjustments when utilizing insulin pumps. Furthermore, the ability to handle such situations as physical exercise, illness, pregnancy, and lactation by making appropriate adjustments in nutrition and pump settings should be cultivated within the patient\u2013practitioner relationship. This review aims to provide healthcare practitioners with practical guidance on optimizing care for individuals living with T1DM. It includes recommendations on carbohydrate counting, managing mixed meals and the glycemic index, addressing exercise-related challenges, coping with illness, and managing nutritional needs during pregnancy and lactation. Additionally, considerations relating to closed-loop systems with regard to nutrition are addressed. By implementing these strategies, healthcare providers can better equip themselves to support individuals with T1DM in achieving improved diabetes management and enhanced quality of life.<\/jats:p>","DOI":"10.3390\/nu15234897","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T11:31:25Z","timestamp":1700739085000},"page":"4897","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A Nutritional Approach to Optimizing Pump Therapy in Type 1 Diabetes Mellitus"],"prefix":"10.3390","volume":"15","author":[{"given":"Evdoxia","family":"Gitsi","sequence":"first","affiliation":[{"name":"Diabetes and Obesity Unit, Athens Medical Center, 15125 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarantis","family":"Livadas","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Athens Medical Center, 15125 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8901-7161","authenticated-orcid":false,"given":"Nicholas","family":"Angelopoulos","sequence":"additional","affiliation":[{"name":"Private Practice, 26 G. Venizelou St., 65302 Kavala, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2804-0859","authenticated-orcid":false,"given":"Rodis","family":"Paparodis","sequence":"additional","affiliation":[{"name":"Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Raftopoulou","sequence":"additional","affiliation":[{"name":"Diabetes and Obesity Unit, Athens Medical Center, 15125 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Argyrakopoulou","sequence":"additional","affiliation":[{"name":"Diabetes and Obesity Unit, Athens Medical Center, 15125 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B.B., Stein, C., Basit, A., Chan, J.C.N., and Mbanya, J.C. (2022). IDF Diabetes Atlas: Global, Regional and Country-Level Diabetes Prevalence Estimates for 2021 and Projections for 2045. Diabetes Res. Clin. Pract., 183.","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"336","DOI":"10.7326\/0003-4819-157-5-201209040-00508","article-title":"Comparative Effectiveness and Safety of Methods of Insulin Delivery and Glucose Monitoring for Diabetes Mellitus: A Systematic Review and Meta-Analysis","volume":"157","author":"Yeh","year":"2012","journal-title":"Ann. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E886","DOI":"10.1152\/ajpendo.00608.2020","article-title":"The Promising Future of Insulin Therapy in Diabetes Mellitus","volume":"320","author":"Cheng","year":"2021","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1111\/jpc.14480","article-title":"Continuous Subcutaneous Insulin Infusion versus Multiple Daily Injections for Type 1 Diabetes","volume":"55","author":"Ross","year":"2019","journal-title":"J. Paediatr. Child Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s12020-016-1039-x","article-title":"Continuous Subcutaneous Insulin Infusion versus Multiple Daily Injections in Individuals with Type 1 Diabetes: A Systematic Review and Meta-Analysis","volume":"55","author":"Benkhadra","year":"2017","journal-title":"Endocrine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s00592-019-01326-5","article-title":"Continuous Subcutaneous Insulin Infusion vs Modern Multiple Injection Regimens in Type 1 Diabetes: An Updated Meta-Analysis of Randomized Clinical Trials","volume":"56","author":"Pala","year":"2019","journal-title":"Acta Diabetol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1007\/s12020-021-02913-9","article-title":"CSII Is Related to More Stable Glycemia in Adults with Type 1 Diabetes","volume":"75","author":"Tsarkova","year":"2022","journal-title":"Endocrine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s42000-018-0054-0","article-title":"Significant Effect of Group Education in Patients with Diabetes Type 1","volume":"17","author":"Mouslech","year":"2018","journal-title":"Hormones"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Al Babtain, S.A., Al Afif, N.O., Al Disi, D., and Al Zahrani, S.H. (2023). Manual and Application-Based Carbohydrate Counting and Glycemic Control in Type 1 Diabetes Subjects: A Narrative Review. Healthcare, 11.","DOI":"10.3390\/healthcare11070934"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1111\/pedi.13429","article-title":"ISPAD Clinical Practice Consensus Guidelines 2022: Nutritional Management in Children and Adolescents with Diabetes","volume":"23","author":"Annan","year":"2022","journal-title":"Pediatr. Diabetes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"823","DOI":"10.2337\/dc10-1490","article-title":"Effects of Carbohydrate Counting on Glucose Control and Quality of Life Over 24 Weeks in Adult Patients with Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion","volume":"34","author":"Laurenzi","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/j.1399-5448.2012.00883.x","article-title":"Carbohydrate Counting with a Bolus Calculator Improves Post-prandial Blood Glucose Levels in Children and Adolescents with Type 1 Diabetes Using Insulin Pumps","volume":"13","author":"Enander","year":"2012","journal-title":"Pediatr. Diabetes"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"984","DOI":"10.2337\/dc11-2044","article-title":"Use of an Automated Bolus Calculator in MDI-Treated Type 1 Diabetes","volume":"35","author":"Schmidt","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Allen, N., and Gupta, A. (2019). Current Diabetes Technology: Striving for the Artificial Pancreas. Diagnostics, 9.","DOI":"10.3390\/diagnostics9010031"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/dom.13052","article-title":"The Challenges of Achieving Postprandial Glucose Control Using Closed-loop Systems in Patients with Type 1 Diabetes","volume":"20","author":"Gingras","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e14511","DOI":"10.1111\/dme.14511","article-title":"In Children and Young People with Type 1 Diabetes Using Pump Therapy, an Additional 40% of the Insulin Dose for a High-fat, High-protein Breakfast Improves Postprandial Glycaemic Excursions: A Cross-over Trial","volume":"38","author":"Smith","year":"2021","journal-title":"Diabet. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.2337\/dc15-0100","article-title":"Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1 Diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era","volume":"38","author":"Bell","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s11892-015-0630-5","article-title":"The Role of Dietary Protein and Fat in Glycaemic Control in Type 1 Diabetes: Implications for Intensive Diabetes Management","volume":"15","author":"Paterson","year":"2015","journal-title":"Curr. Diabetes Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.2337\/dc12-1609","article-title":"Relationships Between Gastric Emptying, Postprandial Glycemia, and Incretin Hormones","volume":"36","author":"Marathe","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1111\/dme.13392","article-title":"Optimizing the Combination Insulin Bolus Split for a High-fat, High-protein Meal in Children and Adolescents Using Insulin Pump Therapy","volume":"34","author":"Lopez","year":"2017","journal-title":"Diabet. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1111\/pedi.13436","article-title":"Efficacy of Insulin Dosing Algorithms for High-fat High-protein Mixed Meals to Control Postprandial Glycemic Excursions in People Living with Type 1 Diabetes: A Systematic Review and Meta-analysis","volume":"23","author":"Balwi","year":"2022","journal-title":"Pediatr. Diabetes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.2337\/dc15-2855","article-title":"Optimized Mealtime Insulin Dosing for Fat and Protein in Type 1 Diabetes: Application of a Model-Based Approach to Derive Insulin Doses for Open-Loop Diabetes Management","volume":"39","author":"Bell","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"810","DOI":"10.2337\/dc12-0092","article-title":"Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients with Type 1 Diabetes","volume":"36","author":"Wolpert","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2695","DOI":"10.1111\/dom.13445","article-title":"Impact of Macronutrient Content of Meals on Postprandial Glucose Control in the Context of Closed-loop Insulin Delivery: A Randomized Cross-over Study","volume":"20","author":"Gingras","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1007\/s00592-015-0716-1","article-title":"Glycaemic Load versus Carbohydrate Counting for Insulin Bolus Calculation in Patients with Type 1 Diabetes on Insulin Pump","volume":"52","author":"Bozzetto","year":"2015","journal-title":"Acta Diabetol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/j.1464-5491.2010.03176.x","article-title":"Effects of Meals with Different Glycaemic Index on Postprandial Blood Glucose Response in Patients with Type 1 Diabetes Treated with Continuous Subcutaneous Insulin Infusion","volume":"28","author":"Parillo","year":"2011","journal-title":"Diabet. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00125-021-05587-0","article-title":"Dietary Determinants of Postprandial Blood Glucose Control in Adults with Type 1 Diabetes on a Hybrid Closed-Loop System","volume":"65","author":"Vetrani","year":"2022","journal-title":"Diabetologia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S120","DOI":"10.2337\/dc14-S120","article-title":"Nutrition Therapy Recommendations for the Management of Adults with Diabetes","volume":"37","author":"Evert","year":"2013","journal-title":"Diabetes Care"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2015). 4 Foundations of Care: Education, Nutrition, Physical Activity, Smoking Cessation, Psychosocial Care, and Immunization. Diabetes Care, 38, S20\u2013S30.","DOI":"10.2337\/dc15-S007"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lupoli, R., Pisano, F., and Capaldo, B. (2019). Postprandial Glucose Control in Type 1 Diabetes: Importance of the Gastric Emptying Rate. Nutrients, 11.","DOI":"10.3390\/nu11071559"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.2337\/dc08-0306","article-title":"Optimizing Postprandial Glycemia in Pediatric Patients with Type 1 Diabetes Using Insulin Pump Therapy","volume":"31","author":"Gilbertson","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e000050","DOI":"10.1136\/bmjdrc-2014-000050","article-title":"Extended Insulin Boluses Cannot Control Postprandial Glycemia as Well as a Standard Bolus in Children and Adults Using Insulin Pump Therapy","volume":"2","author":"Lopez","year":"2014","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1089\/dia.2009.0117","article-title":"Timing of Bolus in Children with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion (TiBoDi Study)","volume":"12","author":"Scaramuzza","year":"2010","journal-title":"Diabetes Technol. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1186\/s13063-022-06173-4","article-title":"Super Bolus: A Remedy for a High Glycemic Index Meal in Children with Type 1 Diabetes on Insulin Pump Therapy?\u2013Study Protocol for a Randomized Controlled Trial","volume":"23","author":"Kowalczyk","year":"2022","journal-title":"Trials"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1016\/j.clnu.2018.11.015","article-title":"Gastrointestinal Effects of Extra-Virgin Olive Oil Associated with Lower Postprandial Glycemia in Type 1 Diabetes","volume":"38","author":"Bozzetto","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"144","DOI":"10.3389\/fendo.2019.00144","article-title":"Impact of Nutrient Type and Sequence on Glucose Tolerance: Physiological Insights and Therapeutic Implications","volume":"10","author":"Nesti","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1111\/pedi.12640","article-title":"The Influence of Food Order on Postprandial Glucose Levels in Children with Type 1 Diabetes","volume":"19","author":"Faber","year":"2018","journal-title":"Pediatr. Diabetes"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Moser, O., Eckstein, M.L., Mueller, A., Tripolt, N.J., Yildirim, H., Abbas, F., Pferschy, P.N., Goswami, N., Aberer, F., and Obermayer, A. (2021). Impact of a Single 36 hours Prolonged Fasting Period in Adults With Type 1 Diabetes\u2013A Cross-Over Controlled Trial. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.656346"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1258\/jrsm.2010.090254","article-title":"Review of Diabetes Management and Guidelines during Ramadan","volume":"103","author":"Karamat","year":"2010","journal-title":"J. R. Soc. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"502","DOI":"10.2337\/cd22-0131","article-title":"The Hypoglycemic Fear Syndrome: Understanding and Addressing This Common Clinical Problem in Adults with Diabetes","volume":"41","author":"Polonsky","year":"2023","journal-title":"Clin. Diabetes"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Templer, S. (2022). Closed-Loop Insulin Delivery Systems: Past, Present, and Future Directions. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.919942"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.clinthera.2008.08.007","article-title":"Suggested Insulin Regimens for Patients with Type 1 Diabetes Mellitus Who Wish to Fast during the Month of Ramadan","volume":"30","author":"Kobeissy","year":"2008","journal-title":"Clin. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1111\/j.1464-5491.2007.02098.x","article-title":"Type 1 Diabetes and Prolonged Fasting","volume":"24","author":"Reiter","year":"2007","journal-title":"Diabet. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.jsps.2018.05.006","article-title":"Higher Rate of Hyperglycemia than Hypoglycemia during Ramadan Fasting in Patients with Uncontrolled Type 1 Diabetes: Insight from Continuous Glucose Monitoring System","volume":"26","author":"Alfadhli","year":"2018","journal-title":"Saudi Pharm. J."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Hassanein, M., Afandi, B., Ahmedani, M.Y., Alamoudi, R.M., Alawadi, F., Bajaj, H.S., Basit, A., Bennakhi, A., Sayed, A.A.E., and Hamdy, O. (2022). Diabetes and Ramadan: Practical Guidelines 2021. Diabetes Res. Clin. Pract., 185.","DOI":"10.1016\/j.diabres.2021.109185"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1089\/dia.2012.0061","article-title":"Ramadan Fasting in Diabetes Patients on Insulin Pump Therapy Augmented by Continuous Glucose Monitoring: An Observational Real-Life Study","volume":"14","author":"Khalil","year":"2012","journal-title":"Diabetes Technol. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1089\/dia.2009.0130","article-title":"Insulin Pump Therapy in Moslem Patients with Type 1 Diabetes During Ramadan Fasting: An Observational Report","volume":"12","author":"Benbarka","year":"2010","journal-title":"Diabetes Technol. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3389\/fendo.2019.00849","article-title":"Intermittent Fasting Could Be Safely Achieved in People with Type 1 Diabetes Undergoing Structured Education and Advanced Glucose Monitoring","volume":"10","author":"Samad","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1089\/dia.2016.0197","article-title":"Does Reducing Basal Insulin During Ramadan Fasting by Children and Adolescents with Type 1 Diabetes Decrease the Risk of Symptomatic Hypoglycemia?","volume":"18","author":"Deeb","year":"2016","journal-title":"Diabetes Technol. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1007\/s00125-021-05568-3","article-title":"The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"64","author":"Holt","year":"2021","journal-title":"Diabetologia"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2019). 5. Lifestyle Management: Standards of Medical Care in Diabetes-2019. Diabetes Care, 42, 46\u201360.","DOI":"10.2337\/dc19-S005"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1007\/s00125-020-05263-9","article-title":"Glucose Management for Exercise Using Continuous Glucose Monitoring (CGM) and Intermittently Scanned CGM (IsCGM) Systems in Type 1 Diabetes: Position Statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) Endorsed by JDRF and Supported by the American Diabetes Association (ADA)","volume":"63","author":"Moser","year":"2020","journal-title":"Diabetologia"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/S2213-8587(17)30014-1","article-title":"Exercise Management in Type 1 Diabetes: A Consensus Statement","volume":"5","author":"Riddell","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1111\/dom.12552","article-title":"Insulin-based Strategies to Prevent Hypoglycaemia during and after Exercise in Adult Patients with Type 1 Diabetes on Pump Therapy: The DIABRASPORT Randomized Study","volume":"17","author":"Franc","year":"2015","journal-title":"Diabetes Obes. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.jcjd.2020.05.014","article-title":"Nutrition and Exercise Performance in Adults with Type 1 Diabetes","volume":"44","author":"Colberg","year":"2020","journal-title":"Can. J. Diabetes"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1177\/1932296815609370","article-title":"Exercise and the Development of the Artificial Pancreas","volume":"9","author":"Riddell","year":"2015","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1007\/s00125-020-05244-y","article-title":"A Single-Blind, Randomised, Crossover Study to Reduce Hypoglycaemia Risk during Postprandial Exercise with Closed-Loop Insulin Delivery in Adults with Type 1 Diabetes: Announced (with or without Bolus Reduction) vs Unannounced Exercise Strategies","volume":"63","author":"Tagougui","year":"2020","journal-title":"Diabetologia"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1111\/dom.12549","article-title":"Safety, Efficacy and Glucose Turnover of Reduced Prandial Boluses during Closed-loop Therapy in Adolescents with Type 1 Diabetes: A Randomized Clinical Trial","volume":"17","author":"Elleri","year":"2015","journal-title":"Diabetes Obes. Metab."},{"key":"ref_59","unstructured":"Gray, A., and Threlkeld, R.J. (2023, September 05). Nutritional Recommendations for Individuals with Diabetes. Endotext, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279012\/."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/dme.13576","article-title":"Weight-based Carbohydrate Treatment of Hypoglycaemia in People with Type 1 Diabetes Using Insulin Pump Therapy: A Randomized Crossover Clinical Trial","volume":"35","author":"McTavish","year":"2018","journal-title":"Diabet. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1210\/jc.2015-4026","article-title":"Effect of Exercise Intensity on Glucose Requirements to Maintain Euglycemia During Exercise in Type 1 Diabetes","volume":"101","author":"Shetty","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1007\/s00421-015-3251-4","article-title":"Evaluation of Glucose Control When a New Strategy of Increased Carbohydrate Supply Is Implemented during Prolonged Physical Exercise in Type 1 Diabetes","volume":"115","author":"Adolfsson","year":"2015","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1249\/MSS.0b013e31823f6557","article-title":"Isomaltulose Improves Glycemia and Maintains Run Performance in Type 1 Diabetes","volume":"44","author":"Bracken","year":"2012","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.2337\/dc14-0186","article-title":"A Low\u2013Glycemic Index Meal and Bedtime Snack Prevents Postprandial Hyperglycemia and Associated Rises in Inflammatory Markers, Providing Protection from Early but Not Late Nocturnal Hypoglycemia Following Evening Exercise in Type 1 Diabetes","volume":"37","author":"Campbell","year":"2014","journal-title":"Diabetes Care"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2999","DOI":"10.1210\/en.2016-1453","article-title":"The Enhancement of Muscle Insulin Sensitivity After Exercise: A Rac1-Independent Handoff to Some Other Player?","volume":"157","author":"Teich","year":"2016","journal-title":"Endocrinology"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/pedi.12193","article-title":"Sick Day Management in Children and Adolescents with Diabetes","volume":"15","author":"Brink","year":"2014","journal-title":"Pediatr. Diabetes"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/pedi.12741","article-title":"ISPAD Clinical Practice Consensus Guidelines 2018: Sick Day Management in Children and Adolescents with Diabetes","volume":"19","author":"Laffel","year":"2018","journal-title":"Pediatr. Diabetes"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/5584_2020_545","article-title":"Diabetes: From Research to Clinical Practice, Volume 4","volume":"1307","author":"Muneer","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_69","first-page":"30","article-title":"Intensive Sick Day Rules to Prevent Recurrent Diabetic Ketoacidosis- An Intervention That Exemplifies Health Disparities","volume":"114","author":"Dye","year":"2022","journal-title":"J. Natl. Med. Assoc."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/S0889-8529(05)70160-2","article-title":"Sick-day management in type 1 diabetes","volume":"29","author":"Laffel","year":"2000","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_71","first-page":"154","article-title":"Type 1 Diabetes: Management Strategies","volume":"98","author":"Smith","year":"2018","journal-title":"Am. Fam. Phys."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"S232","DOI":"10.2337\/dc22-S015","article-title":"15. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2022","volume":"45","author":"Draznin","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1038\/s41574-019-0197-3","article-title":"Improving Pregnancy Outcomes in Women with Diabetes Mellitus: Modern Management","volume":"15","author":"Ringholm","year":"2019","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.bpobgyn.2015.04.009","article-title":"Diabetes in Pregnancy","volume":"29","author":"McCance","year":"2015","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"S254","DOI":"10.2337\/dc23-S015","article-title":"15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes\u20142023","volume":"46","author":"ElSayed","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.jogc.2022.08.010","article-title":"Corrigendum to \u201cGuideline No. 427: Folic Acid and Multivitamin Supplementation for Prevention of Folic Acid\u2013Sensitive Congenital Anomalies\u201d [J. Obstet. Gynaecol. Can. 44 (2022) 707\u2013719]","volume":"44","author":"Wilson","year":"2022","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/dme.13603","article-title":"Diabetes UK Evidence-based Nutrition Guidelines for the Prevention and Management of Diabetes","volume":"35","author":"Dyson","year":"2018","journal-title":"Diabet. Med."},{"key":"ref_78","unstructured":"Institute of Medicine and National Research Council (2009). Weight Gain During Pregnancy: Reexamining the Guidelines."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Thayer, S.M., Williams, K.J., and Lawlor, M.L. (2023). The Role of Technology in the Care of Diabetes Mellitus in Pregnancy: An Expert Review. AJOG Glob. Rep., 3.","DOI":"10.1016\/j.xagr.2023.100245"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.aace.2020.11.039","article-title":"Commercialized Hybrid Closed-Loop System (Minimed Medtronic 670G) Results During Pregnancy","volume":"7","year":"2021","journal-title":"AACE Clin. Case Rep."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ecl.2019.10.006","article-title":"Diabetes Technology Use in Adults with Type 1 and Type 2 Diabetes","volume":"49","author":"Kravarusic","year":"2020","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S2213-8587(23)00116-X","article-title":"Management of Type 1 Diabetes in Pregnancy: Update on Lifestyle, Pharmacological Treatment, and Novel Technologies for Achieving Glycaemic Targets","volume":"11","author":"Benhalima","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Beunen, K., Wilder, N.V., Ballaux, D., Vanhaverbeke, G., Taes, Y., Aers, X.-P., Nobels, F., Marlier, J., Lee, D., and Cuypers, J. (2023). Closed-Loop Insulin Delivery in Pregnant Women with Type 1 Diabetes (CRISTAL): A Multicentre Randomized Controlled Trial\u2013Study Protocol. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05481-0"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Jones, L.V., Ray, A., Moy, F.M., and Buckley, B.S. (2019). Techniques of Monitoring Blood Glucose during Pregnancy for Women with Pre-existing Diabetes. Cochrane Database Syst. Rev., 2019.","DOI":"10.1002\/14651858.CD009613.pub4"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"724","DOI":"10.3109\/14767058.2013.837444","article-title":"Changes in Basal Rates and Bolus Calculator Settings in Insulin Pumps during Pregnancy in Women with Type 1 Diabetes","volume":"27","author":"Mathiesen","year":"2014","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Ringholm, L., N\u00f8rgaard, S.K., Rytter, A., Damm, P., and Mathiesen, E.R. (2022). Dietary Advice to Support Glycaemic Control and Weight Management in Women with Type 1 Diabetes during Pregnancy and Breastfeeding. Nutrients, 14.","DOI":"10.3390\/nu14224867"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3109\/14767058.2014.906577","article-title":"Dietary Advices on Carbohydrate Intake for Pregnant Women with Type 1 Diabetes","volume":"28","author":"Andersen","year":"2015","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"59","DOI":"10.20452\/pamw.1595","article-title":"Medical Care of Pregnant Women with Type 1 Diabetes: Current Guidelines and Clinical Practice","volume":"123","author":"Cyganek","year":"2013","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"282464","DOI":"10.1155\/2010\/282464","article-title":"Glycemic Index and Pregnancy: A Systematic Literature Review","volume":"2010","author":"Louie","year":"2010","journal-title":"J. Nutr. Metab."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/s11892-004-0040-6","article-title":"Lactation, Diabetes, and Nutrition Recommendations","volume":"4","author":"Reader","year":"2004","journal-title":"Curr. Diabetes Rep."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.fertnstert.2022.07.027","article-title":"Nutrition Recommendations for a Healthy Pregnancy and Lactation in Women with Overweight and Obesity\u2013Strategies for Weight Loss before and after Pregnancy","volume":"118","author":"Hart","year":"2022","journal-title":"Fertil. Steril."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.2337\/dc08-9020","article-title":"Managing Preexisting Diabetes for Pregnancy","volume":"31","author":"Kitzmiller","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_93","unstructured":"National Collaborating Centre for Women\u2019s and Children\u2019s Health (UK) (2015). Diabetes in Pregnancy: Management of Diabetes and Its Complications from Preconception to the Postnatal Period, National Institute for Health and Care Excellence (UK)."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"k1310","DOI":"10.1136\/bmj.k1310","article-title":"Artificial Pancreas Treatment for Outpatients with Type 1 Diabetes: Systematic Review and Meta-Analysis","volume":"361","author":"Bekiari","year":"2018","journal-title":"BMJ"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1056\/NEJMoa1907863","article-title":"Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes","volume":"381","author":"Brown","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1056\/NEJMoa2004736","article-title":"A Randomized Trial of Closed-Loop Control in Children with Type 1 Diabetes","volume":"383","author":"Breton","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1111\/dom.14273","article-title":"Hybrid Closed-loop Therapy: Where Are We in 2021?","volume":"23","author":"Leelarathna","year":"2021","journal-title":"Diabetes Obes. Metab."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s00125-021-05391-w","article-title":"New Closed-Loop Insulin Systems","volume":"64","author":"Boughton","year":"2021","journal-title":"Diabetologia"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1210\/endrev\/bnac022","article-title":"Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice","volume":"44","author":"Phillip","year":"2022","journal-title":"Endocr. Rev."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1243237","DOI":"10.3389\/fcdhc.2023.1243237","article-title":"Nutrition Education to Type 1 Diabetes Patients: Few Changes over the Time","volume":"4","author":"Clerc","year":"2023","journal-title":"Front. Clin. Diabetes Healthc."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/1932296819855670","article-title":"Benefits and Limitations of MARD as a Performance Parameter for Continuous Glucose Monitoring in the Interstitial Space","volume":"14","author":"Heinemann","year":"2020","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"3102","DOI":"10.2337\/dc20-1560","article-title":"Lower Daily Carbohydrate Intake Is Associated with Improved Glycemic Control in Adults with Type 1 Diabetes Using a Hybrid Closed-Loop System","volume":"43","author":"Lehmann","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Antoniotti, V., Spadaccini, D., Ricotti, R., Carrera, D., Savastio, S., Correia, F.P.G., Caputo, M., Pozzi, E., Bellone, S., and Rabbone, I. (2022). Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes. Nutrients, 14.","DOI":"10.3390\/nu14030596"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"3327","DOI":"10.1007\/s00394-022-02885-0","article-title":"Adherence to the Mediterranean Diet among Adults in Mediterranean Countries: A Systematic Literature Review","volume":"61","author":"Obeid","year":"2022","journal-title":"Eur. J. Nutr."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1111\/dme.13887","article-title":"The Impact of Using a Closed-loop System on Food Choices and Eating Practices among People with Type 1 Diabetes: A Qualitative Study Involving Adults, Teenagers and Parents","volume":"36","author":"Lawton","year":"2019","journal-title":"Diabet. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/23\/4897\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:28:30Z","timestamp":1760131710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/23\/4897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,23]]},"references-count":105,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["nu15234897"],"URL":"https:\/\/doi.org\/10.3390\/nu15234897","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,23]]}}}