There is an emerging population of older adults (≥65 years) living with type 1 diabetes. Optimizing health through nutrition during this life stage is challenged by multiple and ongoing changes in diabetes management, comorbidities, and lifestyle factors. There is a need to understand nutritional status, dietary intake, and nutrition-related interventions that may maximize well-being throughout the life span in type 1 diabetes, in addition to nutrition recommendations from clinical guidelines and consensus reports. Three reviewers used Cochrane guidelines to screen original research (January 1993–2023) and guidelines (2012–2023) in two databases (MEDLINE and CENTRAL) to characterize nutrition evidence in this population. We found limited original research explicitly focused on nutrition and diet in adults ≥65 years of age with type 1 diabetes (six experimental studies, five observational studies) and meta-analyses/reviews (one scoping review), since in the majority of analyses individuals ≥65 years of age were combined with those age ≥18 years, with diverse diabetes durations, and also individuals with type 1 and type 2 diabetes were combined. Further, existing clinical guidelines (n = 10) lacked specificity and evidence to guide clinical practice and self-management behaviors in this population. From a scientific perspective, little is known about nutrition and diet among older adults with type 1 diabetes, including baseline nutrition status, dietary intake and eating behaviors, and the impact of nutrition interventions on key clinical and patient-oriented outcomes. This likely reflects the population’s recent emergence and unique considerations. Addressing these gaps is foundational to developing evidence-based nutrition practices and guidelines for older adults living with type 1 diabetes.

中文翻译：

---

患有 1 型糖尿病的老年人的营养状况、膳食摄入量和营养相关干预措施：系统评价并呼吁提供更多临床指南证据

患有 1 型糖尿病的老年人群（≥65 岁）正在兴起。在这个生命阶段通过营养优化健康面临着糖尿病管理、合并症和生活方式因素的多重持续变化的挑战。除了临床指南和共识报告中的营养建议外，还需要了解营养状况、饮食摄入量和营养相关干预措施，以最大限度地提高 1 型糖尿病患者整个生命周期的福祉。三位评审员使用 Cochrane 指南筛选两个数据库（MEDLINE 和 CENTRAL）中的原始研究（1993 年 1 月至 2023 年）和指南（2012 年至 2023 年），以描述该人群的营养证据。我们发现明确关注 65 岁以上 1 型糖尿病成人营养和饮食的原始研究有限（六项实验研究，五项观察性研究）和荟萃分析/综述（一项范围界定综述），因为在大多数分析中，个体将年龄≥65岁、年龄≥18岁、糖尿病病程不同的个体合并，并将患有1型和2型糖尿病的个体合并。此外，现有的临床指南（n = 10）缺乏指导该人群临床实践和自我管理行为的特异性和证据。从科学角度来看，人们对 1 型糖尿病老年人的营养和饮食知之甚少，包括基线营养状况、膳食摄入量和饮食行为，以及营养干预对关键临床和以患者为导向的结果的影响。这可能反映了该人群最近的出现和独特的考虑。解决这些差距是为患有 1 型糖尿病的老年人制定循证营养实践和指南的基础。