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Cavallo M, De Fano M, Barana L, Dozzani I, Bianchini E, Pellegrino M, Cisternino L, Migliarelli S, Giulietti C, Pippi R, Fanelli CG. Nutritional Management of Athletes with Type 1 Diabetes: A Narrative Review. Nutrients 2024; 16:907. [PMID: 38542818 PMCID: PMC10975101 DOI: 10.3390/nu16060907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 11/12/2024] Open
Abstract
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.
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Affiliation(s)
- Massimiliano Cavallo
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Piazzale Tristano Di Joannuccio, 1, 05100 Terni, Italy
| | - Michelantonio De Fano
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Luisa Barana
- Diabetology and Endocrinology, Degli Infermi New Hospital of Biella, 13875 Biella, Italy;
| | - Ivan Dozzani
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Eleonora Bianchini
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Marialucia Pellegrino
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Linda Cisternino
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Sara Migliarelli
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Cecilia Giulietti
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
| | - Roberto Pippi
- Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, Via G. Bambagioni, 19, 06126 Perugia, Italy
| | - Carmine Giuseppe Fanelli
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, 06132 Perugia, Italy; (M.D.F.); (I.D.); (E.B.); (M.P.); (L.C.); (C.G.); (C.G.F.)
- Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, Via G. Bambagioni, 19, 06126 Perugia, Italy
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Pan Y, Wang Q, Zhao F, Shen J, Zhong X. Effect of Continuous Subcutaneous Injection of Insulin Analogues in Pregnant Women with Diabetes Mellitus Complicated with Ketoacidosis. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8670474. [PMID: 34956580 PMCID: PMC8694999 DOI: 10.1155/2021/8670474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/13/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the clinical effect of continuous subcutaneous injection of insulin analogues in pregnant women with diabetes mellitus complicated with ketoacidosis. METHODS A total of 92 pregnant patients with diabetes mellitus complicated with ketoacidosis from June 2014 to January 2021 were selected. All patients were randomly divided into an observation group and control group according to the method of random number. The control group received intravenous infusion of insulin, and the observation group received continuous subcutaneous infusion of quick-acting insulin analogues. The clinical effects of the two groups were observed. RESULTS The time needed to control blood glucose <13.8 mmol/L, the amount of insulin needed to control blood glucose <13.8 mmol/L, the time needed to correct DKA, and the amount of insulin needed to correct DKA in the observation group were significantly less than those in the control group (P < 0.05). Compared with the control group, the average occurrence times of hypoglycemia, the length of stay, the total amount of insulin in hospital, and the total amount of insulin used during pregnancy in the observation group were significantly less than those in the control group (P < 0.05). The values of SCr, CRP, BUN, arterial blood gas pH, and adiponectin in the two groups were significantly improved as compared with those before treatment, and the improvement in the observation group was significantly better than that in the control group (P < 0.05). After treatment, the fasting blood glucose, 2-hour postprandial blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin in the experimental group were significantly better than those in the routine group, and the difference was statistically significant (P < 0.05). CONCLUSION Continuous subcutaneous injection of insulin analogues is effective in the treatment of diabetic patients with ketoacidosis, which can effectively improve blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin and accelerate the negative conversion of urinary ketone body. It is worth popularizing to reduce the occurrence of hypoglycemia and the dose of insulin and shorten the time of hospitalization.
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Affiliation(s)
- Yunfei Pan
- General Medicine Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Qi Wang
- Infectious Disease Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Feimin Zhao
- General Medicine Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Jiaying Shen
- General Medicine Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
| | - Xiaojing Zhong
- Endocrinology Department, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, China
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