{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:27:44Z","timestamp":1788316064516,"version":"build-2803163510"},"reference-count":77,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"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>Despite advances in technology, the overall management of type 1 diabetes mellitus (T1DM) remains suboptimal. The idea of restricting carbohydrate intake to decrease glycemic spikes and insulin requirements has been revisited in recent years. After impressive results in the fields of type 2 diabetes (T2DM) and epilepsy, low-carbohydrate (LCD) and ketogenic (KD) diets have gained renewed interest as a possible treatment option for T1DM. In this narrative review, we discuss the available data regarding LCDs and KDs in both the adult and pediatric populations. Research data is still scarce, as most studies are short-term and show considerable heterogeneity in dietary composition and patient outcomes. In general, carbohydrate restriction enhances glycemic control by reducing postprandial glucose excursions, improving time-in-range, and lowering HbA1c, with conflicting effects on other parameters such as lipid profile and body weight. Adverse effects such as hypoglycemia and diabetic ketoacidosis are rarely reported, although some concerns have been raised regarding growth in children. The correct implementation of these diets requires a multidisciplinary approach by highly specialized healthcare professionals, who will address the medical, social, and psychological concerns that a restrictive diet entails. Large-scale and long-term studies are needed to provide more robust data before carbohydrate restriction can be widely applied to patients with T1DM.<\/jats:p>","DOI":"10.3390\/nu17122001","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T05:28:33Z","timestamp":1750051713000},"page":"2001","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Low-Carb and Ketogenic Diets in Type 1 Diabetes: Efficacy and Safety Concerns"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-5488","authenticated-orcid":false,"given":"Emmanouil","family":"Korakas","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, University College London Hospital, London NW1 2BU, UK"},{"name":"2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5829-7327","authenticated-orcid":false,"given":"Aikaterini","family":"Kountouri","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Petrovski","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Sidra Medicine, Doha P.O. Box 26999, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaia","family":"Lambadiari","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2449","DOI":"10.1016\/S0140-6736(18)31320-5","article-title":"Type 1 Diabetes","volume":"391","author":"DiMeglio","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"971","DOI":"10.2337\/dc15-0078","article-title":"Current State of Type 1 Diabetes Treatment in the U.S.: Updated Data from the T1D Exchange Clinic Registry","volume":"38","author":"Miller","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"275","DOI":"10.2337\/diacare.25.2.275","article-title":"Defining the Relationship between Plasma Glucose and HbA(1c): Analysis of Glucose Profiles and HbA(1c) in the Diabetes Control and Complications Trial","volume":"25","author":"Rohlfing","year":"2002","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.2337\/diacare.26.8.2261","article-title":"Low-Glycemic Index Diets in the Management of Diabetes: A Meta-Analysis of Randomized Controlled Trials","volume":"26","author":"Hayne","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"DAFNE Study Group (2002). Training in Flexible, Intensive Insulin Management to Enable Dietary Freedom in People with Type 1 Diabetes: Dose Adjustment for Normal Eating (DAFNE) Randomised Controlled Trial. BMJ, 325, 746.","DOI":"10.1136\/bmj.325.7367.746"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e142246","DOI":"10.1172\/JCI142246","article-title":"Carbohydrate Restriction for Diabetes: Rediscovering Centuries-Old Wisdom","volume":"131","author":"Lennerz","year":"2021","journal-title":"J. Clin. Investig."},{"key":"ref_7","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":"2014","journal-title":"Diabetes Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/0002-8223(93)91750-K","article-title":"Nutrition Interventions for Intensive Therapy in the Diabetes Control and Complications Trial","volume":"93","author":"Anderson","year":"1993","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_9","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. Diabetes"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.bj.2021.11.003","article-title":"Updates on the Ketogenic Diet Therapy for Pediatric Epilepsy","volume":"45","author":"Ko","year":"2021","journal-title":"Biomed. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1038\/s41430-021-01060-8","article-title":"Ketogenic Diet for Epilepsy: An Overview of Systematic Review and Meta-Analysis","volume":"76","author":"Ruan","year":"2022","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/14737175.2022.2030220","article-title":"Ketogenic Diet in Pediatric Seizures: A Randomized Controlled Trial Review and Meta-Analysis","volume":"22","author":"Pizzo","year":"2022","journal-title":"Expert Rev. Neurother."},{"key":"ref_13","first-page":"239","article-title":"Effect of Dietary Carbohydrate Restriction on Glycemic Control in Adults with Diabetes: A Systematic Review and Meta-Analysis. Diabetes Res","volume":"139","author":"Sainsbury","year":"2018","journal-title":"Clin. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e000354","DOI":"10.1136\/bmjdrc-2016-000354","article-title":"Systematic Review and Meta-Analysis of Dietary Carbohydrate Restriction in Patients with Type 2 Diabetes","volume":"5","author":"Snorgaard","year":"2017","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1038\/s41430-017-0019-4","article-title":"The Interpretation and Effect of a Low-Carbohydrate Diet in the Management of Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"72","author":"Huntriss","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Turton, J.L., Raab, R., and Rooney, K.B. (2018). Low-Carbohydrate Diets for Type 1 Diabetes Mellitus: A Systematic Review. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0194987"},{"key":"ref_17","first-page":"1","article-title":"Dietary Carbohydrate Restriction as the First Approach in Diabetes Management: Critical Review and Evidence Base","volume":"31","author":"Feinman","year":"2015","journal-title":"Nutrients"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/0026-0495(83)90105-1","article-title":"The Human Metabolic Response to Chronic Ketosis without Caloric Restriction: Physical and Biochemical Adaptation","volume":"32","author":"Phinney","year":"1983","journal-title":"Metabolism"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1001\/archinte.1977.03630160069014","article-title":"Amino Acid and Protein Metabolism in Diabetes Mellitus","volume":"137","author":"Felig","year":"1977","journal-title":"Arch. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.2337\/db12-0526","article-title":"Fecal Microbiota Composition Differs between Children with \u03b2-Cell Autoimmunity and Those without","volume":"62","author":"Knip","year":"2013","journal-title":"Diabetes"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Endesfelder, D., Engel, M., Davis-Richardson, A.G., Ardissone, A.N., Achenbach, P., Hummel, S., Winkler, C., Atkinson, M., Schatz, D., and Triplett, E. (2016). Towards a Functional Hypothesis Relating Anti-Islet Cell Autoimmunity to the Dietary Impact on Microbial Communities and Butyrate Production. Microbiome, 4.","DOI":"10.1186\/s40168-016-0163-4"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.cmet.2020.05.011","article-title":"Ketone Bodies Exert Ester-Ordinary Suppression of Bifidobacteria and Th17 Cells","volume":"31","author":"Olson","year":"2020","journal-title":"Cell Metab."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Monda, A., La Torre, M.E., Messina, A., Di Maio, G., Monda, V., Moscatelli, F., and Polito, R. (2024). Exploring the Ketogenic Diet\u2019s Potential in Reducing Neuroinflammation and Modulating Immune Responses. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1425816"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kountouri, A., Korakas, E., Ikonomidis, I., Raptis, A., Tentolouris, N., Dimitriadis, G., and Lambadiari, V. (2021). Type 1 Diabetes Mellitus in the SARS-CoV-2 Pandemic: Oxidative Stress as a Major Pathophysiological Mechanism Linked to Adverse Clinical Outcomes. Antioxidants, 10.","DOI":"10.3390\/antiox10050752"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Jawharji, M.T., Alshammari, G.M., Binobead, M.A., Albanyan, N.M., Al-Harbi, L.N., and Yahya, M.A. (2024). Comparative Efficacy of Low-Carbohydrate and Ketogenic Diets on Diabetic Retinopathy and Oxidative Stress in High-Fat Diet-Induced Diabetic Rats. Nutrients, 16.","DOI":"10.3390\/nu16183074"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.brainresrev.2008.09.002","article-title":"The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies","volume":"59","author":"Maalouf","year":"2009","journal-title":"Brain Res. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.cell.2017.01.040","article-title":"Fasting-Mimicking Diet Promotes Ngn3-Driven \u03b2-Cell Regeneration to Reverse Diabetes","volume":"168","author":"Cheng","year":"2017","journal-title":"Cell"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/978-1-0716-0385-7_6","article-title":"Mouse Models of Autoimmune Diabetes: The Nonobese Diabetic (NOD) Mouse","volume":"2128","author":"Chen","year":"2020","journal-title":"Methods Mol Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"699","DOI":"10.5348\/ijcri-2014124-CR-10435","article-title":"Type 1 Diabetes Mellitus Successfully Managed with the Paleolithic Ketogenic Diet","volume":"5","author":"Clemens","year":"2014","journal-title":"Int. J. Case Rep. Images"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1210\/endrev\/bnae032","article-title":"Insulin Resistance in Type 1 Diabetes: Pathophysiological, Clinical, and Therapeutic Relevance","volume":"46","author":"Apostolopoulou","year":"2025","journal-title":"Endocr. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"E1174","DOI":"10.1152\/ajpendo.00279.2003","article-title":"Insulin Resistance, Intramyocellular Lipid Content, and Plasma Adiponectin in Patients with Type 1 Diabetes","volume":"285","author":"Perseghin","year":"2003","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2615","DOI":"10.1007\/s00125-005-0014-5","article-title":"Reduced Intrahepatic Fat Content is Associated with Increased Whole-Body Lipid Oxidation in Patients with Type 1 Diabetes","volume":"48","author":"Perseghin","year":"2005","journal-title":"Diabetologia"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1038\/ijo.2017.96","article-title":"Timeline of Changes in Appetite During Weight Loss with a Ketogenic Diet","volume":"41","author":"Nymo","year":"2017","journal-title":"Int. J. Obes."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.eplepsyres.2016.08.014","article-title":"A Prospective Study on Changes in Blood Levels of Cholecystokinin-8 and Leptin in Patients with Refractory Epilepsy Treated with the Ketogenic Diet","volume":"127","author":"Lambrechts","year":"2016","journal-title":"Epilepsy Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/s41366-023-01429-8","article-title":"The Emergence of Obesity in Type 1 Diabetes","volume":"48","author":"Kueh","year":"2024","journal-title":"Int. J. Obes."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3109\/2000-1967-074","article-title":"A Low Carbohydrate Diet in Type 1 Diabetes: Clinical Experience\u2014A Brief Report","volume":"110","author":"Nielsen","year":"2005","journal-title":"Ups J. Med. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1758-5996-4-23","article-title":"Low Carbohydrate Diet in Type 1 Diabetes, Long-Term Improvement and Adherence: A Clinical Audit","volume":"4","author":"Nielsen","year":"2012","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_38","first-page":"78","article-title":"A Randomised Trial of the Feasibility of a Low Carbohydrate Diet vs Standard Carbohydrate Counting in Adults with Type 1 Diabetes Taking Body Weight into Account","volume":"25","author":"Krebs","year":"2016","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Turton, J., Brinkworth, G., Parker, H., Lim, D., Lee, K., Rush, A., and Rooney, K.B. (2023). Effects of a Low-Carbohydrate Diet in Adults with Type 1 Diabetes Management: A Single Arm Non-Randomised Clinical Trial. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0288440"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1111\/dom.13725","article-title":"Low versus high carbohydrate diet in type 1 diabetes: A 12-week randomized open-label crossover study","volume":"21","author":"Schmidt","year":"2019","journal-title":"Diabetes Obes. Metab."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Kleiner, A., Cum, B., Pisciotta, L., Cincione, I.R., Cogorno, L., Prigione, A., Tramacere, A., Vignati, A., Carmisciano, L., and Sukkar, S.G. (2022). Safety and Efficacy of Eucaloric Very Low-Carb Diet (EVLCD) in Type 1 Diabetes: A One-Year Real-Life Retrospective Experience. Nutrients, 14.","DOI":"10.3390\/nu14153208"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1111\/dme.13663","article-title":"The Glycaemic Benefits of a Very-Low-Carbohydrate Ketogenic Diet in Adults with Type 1 Diabetes Mellitus May Be Opposed by Increased Hypoglycaemia Risk and Dyslipidaemia","volume":"35","author":"Leow","year":"2018","journal-title":"Diabet. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e20173349","DOI":"10.1542\/peds.2017-3349","article-title":"Management of Type 1 Diabetes with a Very Low-Carbohydrate Diet","volume":"141","author":"Lennerz","year":"2018","journal-title":"Pediatrics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1111\/dom.12953","article-title":"Short-Term Effects of a Low Carbohydrate Diet on Glycaemic Variables and Cardiovascular Risk Markers in Patients with Type 1 Diabetes: A Randomized Open-Label Crossover Trial","volume":"19","author":"Ranjan","year":"2017","journal-title":"Diabetes Obes. Metab."},{"key":"ref_45","first-page":"555919","article-title":"Clinical Application of Reduced-Carbohydrate Diets for Type 1 Diabetes Management: A Retrospective Case Series","volume":"15","author":"Turton","year":"2022","journal-title":"Curr. Res. Diabetes Obes. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2770","DOI":"10.1111\/dom.15124","article-title":"Efficacy and safety of carbohydrate restriction in patients with type 1 diabetes: A systematic review and meta-analysis","volume":"25","author":"Stamati","year":"2023","journal-title":"Diabetes Obes. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"132","DOI":"10.2337\/dc16-1472","article-title":"Low-Carbohydrate Diet Impairs the Effect of Glucagon in the Treatment of Insulin-Induced Mild Hypoglycemia: A Randomized Crossover Study","volume":"40","author":"Ranjan","year":"2017","journal-title":"Diabetes Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000000510","article-title":"Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association","volume":"136","author":"Sacks","year":"2017","journal-title":"Circulation"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1136\/archdischild-2018-314973","article-title":"Can a Ketogenic Diet Be Safely Used to Improve Glycaemic Control in a Child with Type 1 Diabetes?","volume":"104","author":"McClean","year":"2019","journal-title":"Arch. Dis. Child."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1111\/j.1528-1167.2010.02543.x","article-title":"Type 1 Diabetes and Epilepsy: Efficacy and Safety of the Ketogenic Diet","volume":"51","author":"Dressler","year":"2010","journal-title":"Epilepsia"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e511","DOI":"10.1542\/peds.2011-0741","article-title":"Successful Treatment of Type 1 Diabetes and Seizures with Combined Ketogenic Diet and Insulin","volume":"129","author":"Castaneda","year":"2012","journal-title":"Pediatrics"},{"key":"ref_52","first-page":"753","article-title":"A Child with Type 1 Diabetes Mellitus (T1DM) Successfully Treated with the Paleolithic Ketogenic Diet: A 19-Month Insulin Freedom","volume":"6","author":"Clemens","year":"2015","journal-title":"Int. J. Case Rep. Images"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/pedi.12527","article-title":"Endocrine and Metabolic Consequences Due to Restrictive Carbohydrate Diets in Children with Type 1 Diabetes: An Illustrative Case Series","volume":"19","author":"Lobley","year":"2018","journal-title":"Pediatr. Diabetes"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/j.jpeds.2011.12.007","article-title":"Growth in Children and Adolescents with Type 1 Diabetes","volume":"160","author":"Bonfig","year":"2012","journal-title":"J. Pediatr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.jpeds.2012.01.037","article-title":"Diabetes Mellitus and Growth in Children and Adolescents","volume":"160","author":"Hannon","year":"2012","journal-title":"J. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"U109","DOI":"10.1530\/eje.0.151u109","article-title":"Growth, Growth Factors and Diabetes","volume":"151","author":"Chiarelli","year":"2004","journal-title":"Eur. J. Endocrinol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.eplepsyres.2017.07.014","article-title":"The Effect of the Ketogenic Diet on the Developing Skeleton","volume":"136","author":"Simm","year":"2017","journal-title":"Epilepsy Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1550-2783-7-24","article-title":"Prevalence of Micronutrient Deficiency in Popular Diet Plans","volume":"7","author":"Calton","year":"2010","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/dme.13845","article-title":"The Ups and Downs of Low-Carbohydrate Diets in the Management of Type 1 Diabetes: A Review of Clinical Outcomes","volume":"36","author":"Seckold","year":"2019","journal-title":"Diabet. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/j.jnutbio.2011.10.013","article-title":"High-Fat Diet Causes Iron Deficiency via Hepcidin-Independent Reduction of Duodenal Iron Absorption","volume":"23","author":"Sonnweber","year":"2012","journal-title":"J. Nutr. Biochem."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1146\/annurev-nutr-071816-064614","article-title":"Dietary fat and risk of cardiovascular disease: Recent controversies and advances","volume":"37","author":"Wang","year":"2017","journal-title":"Annu. Rev. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Toni, G., Berioli, M.G., Cerquiglini, L., Ceccarini, G., Grohmann, U., Principi, N., and Esposito, S. (2017). Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients, 9.","DOI":"10.3390\/nu9080906"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Bombaci, B., Torre, A., Longo, A., Pecoraro, M., Papa, M., Sorrenti, L., La Rocca, M., Lombardo, F., and Salzano, G. (2024). Psychological and Clinical Challenges in the Management of Type 1 Diabetes during Adolescence: A Narrative Review. Children, 11.","DOI":"10.3390\/children11091085"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/j.1747-0080.2012.01604.x","article-title":"How Do Mothers Juggle the Special Dietary Needs of One Child While Feeding the Family? A Qualitative Exploration","volume":"69","author":"Crowley","year":"2012","journal-title":"Nutr. Diet."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s13300-023-01492-4","article-title":"Does a Ketogenic Diet Have a Place within Diabetes Clinical Practice? Review of Current Evidence and Controversies","volume":"15","author":"Firman","year":"2024","journal-title":"Diabetes Ther."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.2337\/dci21-0043","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":"44","author":"Holt","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2025). Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes\u20142025. Diabetes Care, 48, S86\u2013S127.","DOI":"10.2337\/dc25-S005"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"731","DOI":"10.2337\/dci19-0014","article-title":"Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report","volume":"42","author":"Evert","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Dominguez-Riscart, J., Buero-Fernandez, N., Garcia-Zarzuela, A., Morales-Perez, C., Garcia-Ojanguren, A., and Lechuga-Sancho, A.M. (2022). Adherence to Mediterranean Diet Is Associated with Better Glycemic Control in Children with Type 1 Diabetes: A Cross-Sectional Study. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.813989"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Levran, N., Levek, N., Sher, B., Mauda-Yitzhak, E., Gruber, N., Afek, A., Monsonego-Ornan, E., and Pinhas-Hamiel, O. (2023). The Medi-terranean Diet for Adolescents with Type 1 Diabetes: A Prospective Interventional Study. Nutrients, 15.","DOI":"10.20944\/preprints202309.2031.v1"},{"key":"ref_71","first-page":"383","article-title":"Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Glucose Variability in Youth with Type 1 Diabetes","volume":"7","author":"Peairs","year":"2017","journal-title":"Diabetes Manag."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1007\/s00125-007-0775-0","article-title":"The Influence of Dietary Intake and Meal Pattern on Blood Glucose Control in Children and Adolescents Using Intensive Insulin Treatment","volume":"50","author":"Overby","year":"2007","journal-title":"Diabetologia"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1089\/dia.2009.0112","article-title":"Timing of Meal Insulin Boluses to Achieve Optimal Postprandial Glycemic Control in Patients with Type 1 Diabetes","volume":"12","author":"Cobry","year":"2010","journal-title":"Diabetes Technol. Ther."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1093\/nutrit\/nuab040","article-title":"Effect of a very low-carbohydrate ketogenic diet vs. recommended diets in patients with type 2 diabetes: A meta-analysis","volume":"80","author":"Rafiullah","year":"2022","journal-title":"Nutr. Rev."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Barber, T.M., Hanson, P., Kabisch, S., Pfeiffer, A.F.H., and Weickert, M.O. (2021). The low-carbohydrate diet: Short-term metabolic efficacy versus longer-term limitations. Nutrients, 13.","DOI":"10.3390\/nu13041187"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/j.1528-1167.2008.01765.x","article-title":"Optimal Clinical Management of Children Receiving the Ketogenic Diet: Recommendations of the International Ketogenic Diet Study Group","volume":"50","author":"Kossoff","year":"2009","journal-title":"Epilepsia"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1111\/pedi.13179","article-title":"Medical management of children with type 1 diabetes on low-carbohydrate or ketogenic diets","volume":"22","author":"Rydin","year":"2021","journal-title":"Pediatr. Diabetes"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/12\/2001\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:00Z","timestamp":1760032320000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/12\/2001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,14]]},"references-count":77,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["nu17122001"],"URL":"https:\/\/doi.org\/10.3390\/nu17122001","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,14]]}}}