{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:32:01Z","timestamp":1787027521155,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>A retrospective observational cohort study evaluating real\u2010world outcomes in adults with type 1 diabetes and gastroparesis using automated hybrid closed loop insulin delivery systems (HCL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      All adults with type 1 diabetes and gastroparesis attending King's College Hospital diabetes service and using continuous glucose monitoring (CGM) from 5 October 2023 to 16 January 2025 were included. Glycaemic data (HbA\n                      <jats:sub>1c<\/jats:sub>\n                      , CGM metrics), hypoglycaemia awareness (Gold score), diabetes distress (DDS2), and acute complications (DKA, severe hypoglycaemia) were collected from electronic health records and glucose platforms for 12\u2009months pre\u2010 and post\u2010HCL initiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 1827 clinic attendees, 36 adults with gastroparesis were identified, with 17 initiating HCL. HCL and non\u2010HCL groups had comparable baseline characteristics and metrics (HCL: Mean(SD) HbA\n                      <jats:sub>1c<\/jats:sub>\n                      70(21)mmol\/mol [8.6(1.9)%]; Time in range (TIR) 36.8 (21.9) % vs. non\u2010HCL: HbA\n                      <jats:sub>1c<\/jats:sub>\n                      71 (25) mmol\/mol [8.6(2.3)%]; TIR 37.1(19.2)%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.73).\n                    <\/jats:p>\n                    <jats:p>\n                      Post\u2010HCL, HbA\n                      <jats:sub>1c<\/jats:sub>\n                      median(IQR) fell to 57(52.5\u201365.0) mmol\/mol [7.4(7.0\u20138.1)%] (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). TIR increased to 55.7(19.9)% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a significant reduction in Time above range Level 2 (TAR2) [&gt;13.9\u2009mmol\/L\/&gt;250\u2009mg\/dL](32.7% to 14.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). Gold score improved (2.5 to 1.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), but DDS2 remained unchanged. No increase in DKA or severe hypoglycaemia occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Within a specialist multidisciplinary team setting, HCL systems significantly reduce HbA\n                      <jats:sub>1c<\/jats:sub>\n                      without increasing risk of severe hypoglycaemia or DKA in people with type 1 diabetes and gastroparesis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70575","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:48:09Z","timestamp":1771552089000},"page":"3933-3942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A retrospective observational study evaluating the safety and effectiveness of commercially available automated insulin delivery systems in people with type 1 diabetes and gastroparesis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4013-6810","authenticated-orcid":false,"given":"Rachael J. 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