{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:20Z","timestamp":1787014100058,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100032489","name":"Breakthrough T1D Canada","doi-asserted-by":"publisher","award":["3\u2010SRA\u20102024\u20101523\u2010M\u2010N"],"award-info":[{"award-number":["3\u2010SRA\u20102024\u20101523\u2010M\u2010N"]}],"id":[{"id":"10.13039\/100032489","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aim to compare second\u2010generation automated insulin delivery systems (AIDs) with other treatment modalities regarding both glucose management outcomes and person\u2010reported outcomes\/experiences (PROs\/PREs, measured by the Hypoglycemia Fear Survey, Hypoglycemic Confidence Scale, Hyperglycemia Avoidance Scale, Diabetes Distress Scale, Pittsburgh Sleep Quality Index, Well\u2010being Scale, and treatment satisfaction) among adults with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectional analysis of the Canadian BETTER type 1 diabetes registry. Adult participants were divided into five groups: second\u2010generation AIDs, first\u2010generation AIDs, continuous glucose monitoring (CGM)\u2009+\u2009pump, CGM\u2009+\u2009multiple daily injections (MDI), and non\u2010CGM using MDI or pump. Generalized linear models were used to assess differences between the second\u2010generation AID group and each of the other groups, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1731 participants (69.2% females), mean age was 45.3\u2009\u00b1\u200915.3\u2009years with 24.7\u2009\u00b1\u200916.0\u2009years of diabetes. The second\u2010generation AID group had the highest proportion of achieving target haemoglobin A1c\u2009\u2264\u20097% (58.1%) compared to 40.6% in the first\u2010generation AID group, 40.5% in the Pump\u2009+\u2009CGM group, 37.3% in the MDI\u2009+\u2009CGM group, and 32.3% in the non\u2010CGM group, even after adjustment for multiple imbalanced characteristics (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). While second\u2010generation AID users reported higher treatment satisfaction, no other differences in measures of PROs\/PREs were found between second\u2010generation AID and other groups. Elevated diabetes distress (55%) and poor sleep quality (63%) remained common across all treatment groups, and even among those who had reached the optimal HbA1c target (48% and 60%, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In real\u2010world settings, second\u2010generation AIDs were associated with lower haemoglobin A1c and higher treatment satisfaction but not better PROs\/PREs. Mental burden remained high despite the use of advanced diabetes technologies and optimal glucose management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70299","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:09:40Z","timestamp":1763453380000},"page":"1150-1159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Despite lower haemoglobin A1c with second\u2010generation automated insulin delivery systems, mental burden remains high for all adults with type 1 diabetes: A\n                    <scp>BETTER<\/scp>\n                    registry analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0671-1888","authenticated-orcid":false,"given":"Zekai","family":"Wu","sequence":"first","affiliation":[{"name":"Division of Experimental Medicine, Department of Medicine McGill University  Montreal Quebec 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