{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:18:40Z","timestamp":1790885920556,"version":"4.1.0"},"reference-count":80,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"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>Type 1 diabetes mellitus (T1DM) represents a complex clinical challenge for health systems. The autoimmune destruction of pancreatic beta cells leads to a complete lack of insulin production, exposing people to a lifelong risk of acute (DKA, coma) and chronic complications (macro and microvascular). Physical activity (PA) has widely demonstrated its efficacy in helping diabetes treatment. Nutritional management of people living with T1DM is particularly difficult. Balancing macronutrients, their effects on glycemic control, and insulin treatment represents a complex clinical challenge for the diabetologist. The effects of PA on glycemic control are largely unpredictable depending on many individual factors, such as intensity, nutrient co-ingestion, and many others. Due to this clinical complexity, we have reviewed the actual scientific literature in depth to help diabetologists, sport medicine doctors, nutritionists, and all the health figures involved in diabetes care to ameliorate both glycemic control and the nutritional status of T1DM people engaging in PA. Two electronic databases (PubMed and Scopus) were searched from their inception to January 2024. The main recommendations for carbohydrate and protein ingestion before, during, and immediately after PA are explained. Glycemic management during such activity is widely reviewed. Micronutrient needs and nutritional supplement effects are also highlighted in this paper.<\/jats:p>","DOI":"10.3390\/nu16060907","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T06:35:30Z","timestamp":1711002930000},"page":"907","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Nutritional Management of Athletes with Type 1 Diabetes: A Narrative Review"],"prefix":"10.3390","volume":"16","author":[{"given":"Massimiliano","family":"Cavallo","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2657-5991","authenticated-orcid":false,"given":"Michelantonio","family":"De Fano","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Barana","sequence":"additional","affiliation":[{"name":"Diabetology and Endocrinology, Degli Infermi New Hospital of Biella, 13875 Biella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5595-7992","authenticated-orcid":false,"given":"Ivan","family":"Dozzani","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Bianchini","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marialucia","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Cisternino","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Migliarelli","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Giulietti","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0429-4996","authenticated-orcid":false,"given":"Roberto","family":"Pippi","sequence":"additional","affiliation":[{"name":"Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attivit\u00e0 Motoria), Department of Medicine and Surgery, University of Perugia, Via G. Bambagioni, 19, 06126 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-158X","authenticated-orcid":false,"given":"Carmine Giuseppe","family":"Fanelli","sequence":"additional","affiliation":[{"name":"Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy"},{"name":"Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attivit\u00e0 Motoria), Department of Medicine and Surgery, University of Perugia, Via G. Bambagioni, 19, 06126 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"ref_1","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_2","doi-asserted-by":"crossref","unstructured":"Moser, O., Eckstein, M.L., Mueller, A., Birnbaumer, P., Aberer, F., Koehler, G., Sourij, C., Kojzar, H., Pferschy, P., and Dietz, P. (2019). Pre-Exercise Blood Glucose Levels Determine the Amount of Orally Administered Carbohydrates during Physical Exercise in Individuals with Type 1 Diabetes-A Randomized Cross-Over Trial. 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