{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:32Z","timestamp":1790927672632,"version":"4.1.0"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Res Paediatr"],"abstract":"<jats:p>Background \u2014 Optimal management of insulin-treated pediatric and adolescent diabetes, particularly type 1 diabetes (T1D), requires precise insulin dosing and sick-day decision-making; deficiencies in either predispose to hypoglycemia, suboptimal glycaemic control, and diabetic ketoacidosis. We developed DiaBuddy\u2122, a guideline-aligned mobile decision support tool, and evaluated its accuracy versus expert guidance and clinical changes observed during pilot evaluation in children and adolescents with insulin-treated diabetes. Methods \u2014 The preclinical validation compared DiaBuddy and family recommendations (N = 37) for 20 insulin-dosing and 20 sick-day vignettes against a pediatric endocrinologist gold standard. The prospective single-arm pilot study explored changes over 12 weeks in 20 children and adolescents with insulin-treated diabetes. HbA1c was the primary clinical outcome; CGM-derived metrics, PedsQL quality-of-life scores, application use, and satisfaction were exploratory secondary outcomes. Results \u2014 In the preclinical study, DiaBuddy showed lower absolute relative deviation for basal (5.0 \u00b1 6.7% vs 24.2 \u00b1 25.9%), bolus (6.9 \u00b1 10.9% vs 45.3 \u00b1 48.8%), and combined doses (6.3 \u00b1 9.3% vs 39.0 \u00b1 37.8%; all P &lt; 0.001) than families. DiaBuddy\u2122 achieved \u226590% accuracy across all sick-day domains versus 27\u201370% for families; and provided a guideline-concordant response in 94.5% of instances in which family responses were erroneous, including all instances involving an incorrect family hospitalisation decision. In the clinical study, HbA1c declined from 9.18 \u00b1 1.99% to 8.48 \u00b1 1.44% (p = 0.049) and the PedsQL score increased from 76.5 \u00b1 8.6 to 89.1 \u00b1 7.1 (+12.6 points, P &lt; 0.001) with no change in CGM metrics. Application satisfaction was high (mean score 44.1 \u00b1 4.1 out of 50) with most wishing to continue using it. Conclusions \u2014 DiaBuddy delivered guideline-aligned guidance in vignette testing. In this single-centre, uncontrolled pilot, observed changes in HbA1c and PedsQL are hypothesis-generating and require evaluation in an adequately powered multicentre randomised controlled trial.<\/jats:p>","DOI":"10.1159\/hrp\/adaag032","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:19:06Z","timestamp":1790335146000},"source":"Crossref","is-referenced-by-count":0,"title":["Development and Pilot Clinical Evaluation of DiaBuddy, a Point-of-Care Decision Support Tool for Children and Adolescents with Insulin-Treated Diabetes"],"prefix":"10.1159","author":[{"given":"Alapan","family":"Mahapatra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Paimode","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayan","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Shukla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimisha","family":"Sachan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibha","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Bajpai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,1]]},"container-title":["Hormone Research in Paediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/hrp\/adaag032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:18:04Z","timestamp":1790925484000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/hrp\/adaag032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/hrp\/adaag032","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.34022517","asserted-by":"subject"}]},"ISSN":["1663-2818","1663-2826"],"issn-type":[{"value":"1663-2818","type":"print"},{"value":"1663-2826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]}}}