{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:43:16Z","timestamp":1777556596750,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>People with type 1 diabetes and executive function (EF) challenges (e.g., organization) often struggle with self-care. This study evaluated risks\/benefits of insulin pumps in teens with EF challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design\/Methods:<\/jats:title>\n                    <jats:p>Parents of teens with type 1 diabetes completed parent-reported Behavior Rating Inventory of Executive Function. Severe hypoglycemia (SH) and diabetic ketoacidosis\/hyperglycemia (DKA) events, collected prospectively, provided incidence rates (IR). A1c differences by pump use were compared by the presence\/absence of EF challenges (Global Executive Composite score, EF indices). Adjusted multivariable models predicted A1c. Differences in SH and DKA IRs were evaluated by pump use and EF status, employing Poisson regressions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In teens with EF challenges, pump-users versus nonusers had lower A1c (8.5% vs. 9.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009). There were no A1c differences by pump use\/nonuse in those without EF challenges. In multivariable analysis, A1c differences remained for those with EF challenges by one index; A1c was 0.65% lower in pump-users versus nonusers (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028). SH incidence did not differ by pump use or EF status. DKA incidence was lower in pump-users than nonusers (4.9 vs. 14.0 episodes\/100-person-years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012) and lower in teens without than with EF challenges (4.9 vs. 14.0\/100-person-years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012). In those without EF challenges, pump-users had lower DKA IR than nonpump-users (2.0 vs. 13.7\/100-person-years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). In those with EF challenges, DKA IRs did not differ by pump use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite occasional prescriber hesitancy, teens with type 1 diabetes and EF challenges using insulin pumps had lower A1c without increased DKA risk compared with nonpump-users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2024.0574","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T10:34:05Z","timestamp":1738838045000},"page":"460-468","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Teens with Type 1 Diabetes and Executive Function Challenges Who Use Insulin Pumps Have Lower A1C Without Increased Risk of Diabetic Ketoacidosis or Severe Hypoglycemia"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6012-027X","authenticated-orcid":false,"given":"Rebecca J.","family":"Vitale","sequence":"first","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA."},{"name":"Division of Endocrinology, Department of Medicine, Brigham &amp; Women\u2019s Hospital, Boston, Massachusetts, USA."},{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Boston Children\u2019s Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liane J.","family":"Tinsley","sequence":"additional","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa K.","family":"Volkening","sequence":"additional","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-3001","authenticated-orcid":false,"given":"Lori M.","family":"Laffel","sequence":"additional","affiliation":[{"name":"Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA."},{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Boston Children\u2019s Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31320-5"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-009-9097-4"},{"key":"e_1_3_5_4_2","first-page":"1191","article-title":"A review of executive function deficits in autism spectrum disorder and attention-deficit\/hyperactivity disorder","volume":"12","author":"Craig F","year":"2016","unstructured":"Craig F, , Margari F, , Legrottaglie AR, et al. A review of executive function deficits in autism spectrum disorder and attention-deficit\/hyperactivity disorder. Neuropsychiatr Dis Treat, 2016; 12:1191\u20131202.","journal-title":"Neuropsychiatr Dis Treat"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-012-0311-6"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0078"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd22-0067"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd22-0073"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0032804"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1076\/jcen.25.2.242.13639"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1723"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617719001310"},{"key":"e_1_3_5_13_2","article-title":"Lower independent self-care readiness persists over time in teens with Type 1 diabetes and executive function challenges","author":"Vitale RJ","year":"2024","unstructured":"Vitale RJ, , Tinsley LJ, , Volkening LK, , Laffel LM. Lower independent self-care readiness persists over time in teens with Type 1 diabetes and executive function challenges. J Clin Endocrinol Metab, 2024.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573399811666150421114146"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(86)80852-6"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(97)70352-4"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.5.713"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2020.0572"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6940"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.2165\/00024677-200302010-00002"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12879"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-019-01326-5"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2019.0350"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-8106-5_18"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0734282906288390"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781118548387"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-0345"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-1134"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.12.009"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2007.02311.x"}],"container-title":["Diabetes Technology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/dia.2024.0574","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/dia.2024.0574","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/dia.2024.0574","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:15:12Z","timestamp":1777400112000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/dia.2024.0574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1089\/dia.2024.0574"],"URL":"https:\/\/doi.org\/10.1089\/dia.2024.0574","relation":{},"ISSN":["1520-9156","1557-8593"],"issn-type":[{"value":"1520-9156","type":"print"},{"value":"1557-8593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}