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Nutrients
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Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes
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Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Diabetes".

Deadline for manuscript submissions: 5 November 2025 | Viewed by 13077

Special Issue Editors

Dr. Maria Papagianni

E-Mail Website
Guest Editor
1. Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
2. Unit of Pediatric Endocrinology, Diabetes Mellitus and Metabolism, 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Hippokrateion Hospital of Thessaloniki, 54642 Thessaloniki, Greece
Interests: nutrition; pediatric endocrinology; diabetes; metabolism; endocrine disruptors
Dr. Dario Rahelić

E-Mail Website
Guest Editor
1. Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Disorders, Merkur University Hospital, 10000 Zagreb, Croatia
2. School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
3. School of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Interests: endocrinology; diabetes; metabolic diseases; diabetes and nutrition
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. George Mastorakos

E-Mail Website
Guest Editor
Unit of Endocrinology, Diabetes Mellitus and Metabolism, Unit of Endocrinology of Exercise and Athletics, "Aretaieion" Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
Interests: metabolism; gestational diabetes; PCOs; endocrinology of the woman; immune and inflammatory disorders in relation to stress system response; endocrinology of exercise and physical activity; endocrine disruptors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The significant increase in the incidence of type 1 diabetes in recent decades, especially in younger age groups, necessitates the ever-greater involvement of the medical community in the treatment of this disease and prevention of its complications. Nutrition is an important factor in the management of diabetes. During the past decade, the rapid expansion of the amount of population-based epidemiological evidence has helped to clarify the significant role of diet in the prevention, treatment, and control of morbidity, as well as premature mortality as a result of chronic childhood diseases. In addition to diet, lifestyle has a significant impact on glycemic control in patients with diabetes. The outstanding achievements of technology such as continuous glucose monitoring systems, continuous insulin infusion systems, and hybrid closed-loop systems have radically changed the way diabetes is treated today. Nevertheless, the role of diet and lifestyle in the glycemic control of patients with type 1 diabetes remains crucial.

This Special Issue includes manuscripts that focus on nutrition, diet, and/or lifestyle interventions regarding the prevention and management of type 1 diabetes mellitus and its complications. The included authors are experts in this field and the provided materials are the result of their experience or internationally acquired scientific knowledge. The content is useful for endocrinologists, pediatric endocrinologists, diabetologists, pediatric diabetologists, pediatricians, dieticians, nutritionists, ergophysiologists, trainers, and will inspire further innovative research.

Dr. Maria Papagianni
Dr. Dario Rahelić
Prof. Dr. George Mastorakos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutrition
  • diet
  • lifestyle
  • type 1 diabetes mellitus
  • exercise
  • autoimmunity
  • endocrine disruptors
  • physical activity

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Published Papers (5 papers)

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Research

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14 pages, 1203 KiB  
Article
Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
by Olivia M. McCarthy, Merete Bechmann Christensen, Sandra Tawfik, Kasper Birch Kristensen, Bolette Hartmann, Jens Juul Holst, Signe Schmidt, Kirsten Nørgaard and Richard M. Bracken
Nutrients 2024, 16(23), 4098; https://doi.org/10.3390/nu16234098 - 28 Nov 2024
Viewed by 1604
Abstract
Objectives: This article compares metabolic, pancreatic, and gut-derived hormone responses to isomaltulose ingestion, before versus during submaximal sustained exercise, in adults with type 1 diabetes (T1D) using automated insulin delivery systems. Methods: In a randomized, cross-over trial, eight participants with T1D being treated [...] Read more.
Objectives: This article compares metabolic, pancreatic, and gut-derived hormone responses to isomaltulose ingestion, before versus during submaximal sustained exercise, in adults with type 1 diabetes (T1D) using automated insulin delivery systems. Methods: In a randomized, cross-over trial, eight participants with T1D being treated with automated insulin pumps (five females, age: 47 ± 16 years, BMI: 27.5 ± 3.8 kg·m2, diabetes duration: 23 ± 11 years, HbA1c: 8.3 ± 0.9 [67.5 ± 9.5]% [mmol/mol]) attended the laboratory on two separate occasions and consumed an isocaloric amount of isomaltulose as either (1) a single serving (0.75g CHO·kg−1 BM) with a 25% reduction in bolus insulin 90 min before 45 min of cycling (PEC) or (2) three separate isocaloric servings (0.25g CHO·kg−1 BM each) without bolus insulin during exercise (DEC). Plasma glucose (PG), gut incretins (GLP-1 and GIP), pancreatic glucagon, exogenous insulin, and whole-body fuel oxidation rates were determined. Data were treated via a two-way repeated measures ANOVA, with p ≤ 0.05 accepted as significant. Results: PG concentrations throughout exercise were higher and less variable with DEC compared to PEC. The exercise-induced change in PG was directionally divergent between trials (PEC: ∆ − 3.2 ± 1.2 mmol/L vs. DEC: ∆ + 1.7 ± 1.5 mmol/L, p < 0.001), changing at a rate of −0.07 ± 0.03 mmol/L/min with PEC and +0.04 ± 0.03 mmol/L/min with DEC (p < 0.001 between conditions). Throughout the exercise period, GLP-1, GIP, glucagon, and total insulin concentrations were lower with DEC (all p ≤ 0.02). The oxidation rates of carbohydrates were lower (p = 0.009) and of lipids were greater (p = 0.014) with DEC compared to PEC. Conclusions: The consumption of smaller servings of isomaltulose during, rather than as a single isocaloric serving before, submaximal sustained exercise provided (i) a better glycemic protective effect, (ii) a lesser push on pancreatic and gut-mediated glucoregulatory hormones, and (iii) a lower reliance on whole-body carbohydrate oxidation. Such information serves to remind us of the potential importance of nutrition for modulating the metabolic fate of an acute bout of exercise and may help inform best practice guidelines for exercise management in the T1D-sphere. Full article
(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)
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16 pages, 339 KiB  
Article
Exploring Determinants of Health-Related Quality of Life in Emerging Adults with Type 1 Diabetes Mellitus: A Cross-Sectional Analysis
by María-Ángeles Núñez-Baila, Anjhara Gómez-Aragón, Armando-Manuel Marques-Silva and José Rafael González-López
Nutrients 2024, 16(13), 2059; https://doi.org/10.3390/nu16132059 - 28 Jun 2024
Cited by 1 | Viewed by 2143
Abstract
(1) Background: Emerging adulthood, from the age of 18 to 29 years, is a crucial phase for individuals with Type 1 Diabetes Mellitus, as it affects their Health-Related Quality of Life. (2) Methods: This cross-sectional study analyzes the influence of the Mediterranean diet, [...] Read more.
(1) Background: Emerging adulthood, from the age of 18 to 29 years, is a crucial phase for individuals with Type 1 Diabetes Mellitus, as it affects their Health-Related Quality of Life. (2) Methods: This cross-sectional study analyzes the influence of the Mediterranean diet, Diabetes duration, Hemoglobin A1c, and sleep disorders on Health-Relate Quality of Life in Type 1 Diabetes Mellitus. In this study, conducted in Andalusia, Spain, 362 emerging adults with Type 1 Diabetes Mellitus completed the Oviedo Sleep Questionnaire, the Adaptation of Mediterranean Diet Adherence Screener, and the Vida con Diabetes Tipo 1 (ViDa1) Health-Related Quality of Life questionnaire between October 2021 and July 2022. Pearson correlation coefficients and a multiple regression analysis were conducted for each Health-Related Quality of Life in Type 1 Diabetes Mellitus dimension (Interference with Life, Well-being, Self-care, and Concern about the Condition) for overall sample and separately for males and females. (3) Results: Different and significant correlations are found among factors such as Age, Body Mass Index, Currently being a student, Hemoglobin A1c, Sleep satisfaction, Insomnia, Hypersomnolence, and Adherence to Mediterranean diet. Notably, Insomnia is a main predictor for Interference with Life, Well-being, and Concern about the Condition, especially for females. (4) Conclusions: Insomnia is the main predictor of Health-Related Quality of Life in Type 1 Diabetes Mellitus among Andalusian emerging adults with this condition. Consequently, a regular assessment of sleep and Health-Related Quality of Life from a gender perspective in this age group is crucial. Full article
(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)
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Review

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8 pages, 227 KiB  
Review
Nutrition and Glycemic Control in Children and Adolescents with Type 1 Diabetes Mellitus Attending Diabetes Camps
by Kleoniki I. Athanasiadou, Maria Papagianni, Theodora Psaltopoulou and Stavroula A. Paschou
Nutrients 2024, 16(19), 3338; https://doi.org/10.3390/nu16193338 - 1 Oct 2024
Viewed by 2198
Abstract
Background/Objectives: Diabetes camps for children and adolescents with Type 1 Diabetes mellitus (T1DM) offer the opportunity to have a camping experience in a safe and supportive environment where they can receive diabetes skills education, such as glucose self-monitoring, insulin injections, management of hypoglycemia/hyperglycemia, [...] Read more.
Background/Objectives: Diabetes camps for children and adolescents with Type 1 Diabetes mellitus (T1DM) offer the opportunity to have a camping experience in a safe and supportive environment where they can receive diabetes skills education, such as glucose self-monitoring, insulin injections, management of hypoglycemia/hyperglycemia, and nutritional recommendations, including meal planning and carbohydrate counting. The ultimate goal of diabetes camps is to educate children to manage their condition independently, without parental involvement. Additionally, attending a diabetes camp is an excellent opportunity to meet peers and share their experiences and concerns about their condition, enhancing their confidence and reducing diabetes-related emotional distress. The aim of this review was to assess whether the nutritional planning and education offered at diabetes camps has a favorable effect on the glycemic control of attending children and adolescents. Methods: A literature search in PubMed and Scopus databases was performed. Eligible for inclusion were studies evaluating the effect of nutritional education offered in diabetes camps on glycemic control of children and adolescents with T1DM. Results: The majority of identified eligible studies supported the beneficial impact of the nutritional education offered in diabetes camps on glycemic control during and after the camp sessions. The favorable effect, though, seemed to be temporarily sustained (<6 months). Conclusions: Continuous nutritional education is required to prolong the duration of these beneficial outcomes. Further interventional studies are required to evaluate the direct effect of nutritional education provided at diabetes camps on glycemic control of children and adolescents with T1DM and the actual duration of favorable outcomes. Full article
(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)
17 pages, 373 KiB  
Review
A Nutritional Approach to Optimizing Pump Therapy in Type 1 Diabetes Mellitus
by Evdoxia Gitsi, Sarantis Livadas, Nicholas Angelopoulos, Rodis D. Paparodis, Marina Raftopoulou and Georgia Argyrakopoulou
Nutrients 2023, 15(23), 4897; https://doi.org/10.3390/nu15234897 - 23 Nov 2023
Cited by 3 | Viewed by 4336
Abstract
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 [...] Read more.
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–practitioner 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. Full article
(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)

Other

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13 pages, 2019 KiB  
Systematic Review
Impact of Probiotics on the Glycemic Control of Pediatric and Adolescent Individuals with Type 1 Diabetes: A Systematic Review and Meta-Analysis
by Charikleia Stefanaki, Paraskevi Rozou, Vasiliki Efthymiou, Ioannis Xinias, George Mastorakos, Flora Bacopoulou and Maria Papagianni
Nutrients 2024, 16(16), 2629; https://doi.org/10.3390/nu16162629 - 9 Aug 2024
Cited by 2 | Viewed by 2179
Abstract
Aims: Human recombinant insulin is currently the only therapy for children and adolescents with type 1 diabetes (T1D), although not always efficient for the glycemic control of these individuals. The interrelation between the gut microbiome and the glycemic control of apparently healthy populations, [...] Read more.
Aims: Human recombinant insulin is currently the only therapy for children and adolescents with type 1 diabetes (T1D), although not always efficient for the glycemic control of these individuals. The interrelation between the gut microbiome and the glycemic control of apparently healthy populations, as well as various populations with diabetes, is undeniable. Probiotics are biotherapeutics that deliver active components to various targets, primarily the gastrointestinal tract. This systematic review and meta-analysis examined the effect of the administration of probiotics on the glycemic control of pediatric and adolescent individuals with T1D. Materials and Methods: Randomized controlled trials employing the administration of probiotics in children and adolescents with T1D (with ≥10 individuals per treatment arm), written in English, providing parameters of glycemic control, such as mean glucose concentrations and glycosylated hemoglobin (HbA1c), were deemed eligible. Results: The search strategy resulted in six papers with contradictory findings. Ultimately, five studies of acceptable quality, comprising 388 children and adolescents with T1D, were included in the meta-analysis. Employing a random and fixed effects model revealed statistically significant negative effect sizes of probiotics on the glycemic control of those individuals, i.e., higher concentrations of glucose and HbA1c than controls. Conclusions: Children and adolescents with T1D who received probiotics demonstrated worse glycemic control than controls after the intervention. Adequately powered studies, with extended follow-up periods, along with monitoring of compliance and employing the proper strains, are required to unravel the mechanisms of action and the relative effects of probiotics, particularly concerning diabetes-related complications and metabolic outcomes. Full article
(This article belongs to the Special Issue Advances in Nutrition and Lifestyle Interventions for Type 1 Diabetes)
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