{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:35:24Z","timestamp":1787312124287,"version":"build-2736575974"},"reference-count":64,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100015526","name":"Ministry of Science and Education","doi-asserted-by":"crossref","award":["\u201cPerly Nauki 1\u201d (PN\/01\/0025\/2022; JC)"],"award-info":[{"award-number":["\u201cPerly Nauki 1\u201d (PN\/01\/0025\/2022; JC)"]}],"id":[{"id":"10.13039\/100015526","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Diabetes Poland","award":["Research grant (awarded to AM)"],"award-info":[{"award-number":["Research grant (awarded to AM)"]}]},{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"crossref","award":["PRELUDIUM 22 (2023\/49\/N\/NZ5\/02321; AM)"],"award-info":[{"award-number":["PRELUDIUM 22 (2023\/49\/N\/NZ5\/02321; AM)"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"crossref","award":["PRELUDIUM BIS 4 (2022\/47\/O\/NZ5\/00683; JC)"],"award-info":[{"award-number":["PRELUDIUM BIS 4 (2022\/47\/O\/NZ5\/00683; JC)"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ko\u015bciuszko Foundation","award":["Research exchange programme (awarded to AM)"],"award-info":[{"award-number":["Research exchange programme (awarded to AM)"]}]},{"DOI":"10.13039\/501100005888","name":"Medical University of Lodz","doi-asserted-by":"crossref","award":["BRaIn P1 grant (awarded to AM and JC)"],"award-info":[{"award-number":["BRaIn P1 grant (awarded to AM and JC)"]}],"id":[{"id":"10.13039\/501100005888","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001870","name":"Foundation for Polish Science","doi-asserted-by":"crossref","award":["START programme (awarded to AM and JC)"],"award-info":[{"award-number":["START programme (awarded to AM and JC)"]}],"id":[{"id":"10.13039\/501100001870","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100008813","name":"International Society for Pediatric and Adolescent Diabetes","doi-asserted-by":"crossref","award":["ISPAD-Breakthrough T1D fellowship (awarded to JC)"],"award-info":[{"award-number":["ISPAD-Breakthrough T1D fellowship (awarded to JC)"]}],"id":[{"id":"10.13039\/501100008813","id-type":"DOI","asserted-by":"crossref"}]},{"name":"CRIDO","award":["\u201cKorzenie Przyszlosci\u201d (awarded to JC)"],"award-info":[{"award-number":["\u201cKorzenie Przyszlosci\u201d (awarded to JC)"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Optimizing hybrid closed-loop (HCL) performance around exercise in children with type 1 diabetes (T1D) is challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective, randomized, controlled pilot study conducted during a 7-day holiday camp, participants using Medtronic MiniMed 780 G and continuous glucose monitoring (CGM) were randomized to two strategies of HCL use for physical activity (1\u20132 sessions\/day): pump kept connected in auto-mode versus suspended and disconnected. Meal boluses before exercise were not reduced, and all participants used 90-min pre-exercise temporary glucose target 150 mg\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 20, 8 and 7 participants from connected and disconnected arms were eligible for analysis. Median age was 11 (10\u201311) years, diabetes duration was 1.6 (0.7\u20136.0) years, HbA1c was 6.4 (6.05\u20137.3)% (46, 43\u201356 mmol\/mol), and BMI z-score was \u22120.25 (\u22120.53\u20131.36). HCL exercise disconnection resulted in lower time below range &lt;70 mg\/dL [3.9 mmol\/L] during camp (\u22122.91\u2009\u00b1\u20091.3%point difference,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0250), with no difference in time in range 70\u2013180 mg\/dL [3.9\u201310.0 mmol\/L] (+0.3\u2009\u00b1\u20094.8%point,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.1677).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Temporary HCL disconnection for exercise significantly reduces hypoglycemia risk without compromising glucose control.<\/jats:p>\n                    <jats:p>\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" orientation=\"portrait\" position=\"float\" xlink:href=\"10.1177_15209156251390825-fig2.tif\"\/>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15209156251390825","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:18:00Z","timestamp":1769159880000},"page":"392-400","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid Closed-Loop Disconnection Reduces the Risk of Hypoglycemia in Active Children and Adolescents with Type 1 Diabetes: A Randomized Controlled Pilot Study"],"prefix":"10.1177","volume":"28","author":[{"given":"J\u0119drzej","family":"Chrzanowski","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Olejniczak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"R\u00f3\u017cycka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arkadiusz","family":"Michalak","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, Poland."},{"name":"Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Fendler","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Szadkowska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-017-0978-x"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaf136"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd24-0100"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.2174\/1381612826666200108113002"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107810"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2022.2086489"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2024.111981"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.2337\/dsi22-0019"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15482"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1123\/pes.2018-0264"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05183-8"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1113\/JP285836"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06308-z"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112445"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2311"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.2337\/ds18-0016"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000542204"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00319-9"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci19-0028"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2012.12.001"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-0534"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-010-1329-x"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968221101916"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-022-01929-5"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0433"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13440"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-00996-7"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1332418"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.5114\/ctd\/203685"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1907863"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0255"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2021.0319"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968221088327"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2217"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-0276"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2024.0254"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0373"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0380"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15333"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15766"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01789-5"},{"key":"e_1_3_7_43_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0720"},{"key":"e_1_3_7_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-024-05551-1"},{"key":"e_1_3_7_45_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-0898"},{"key":"e_1_3_7_46_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0542"},{"key":"e_1_3_7_47_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae792"},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06229-x"},{"key":"e_1_3_7_49_2","doi-asserted-by":"publisher","DOI":"10.2337\/dsi22-0018"},{"key":"e_1_3_7_50_2","doi-asserted-by":"publisher","DOI":"10.2337\/diaspect.28.1.55"},{"key":"e_1_3_7_51_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0420"},{"key":"e_1_3_7_52_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0153"},{"key":"e_1_3_7_53_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2024.0048"},{"key":"e_1_3_7_54_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0293"},{"key":"e_1_3_7_55_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2014.0342"},{"key":"e_1_3_7_56_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2013.0139"},{"key":"e_1_3_7_57_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968211009538"},{"key":"e_1_3_7_58_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1283181"},{"key":"e_1_3_7_59_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0029"},{"key":"e_1_3_7_60_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0284"},{"key":"e_1_3_7_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231156572"},{"key":"e_1_3_7_62_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0535"},{"key":"e_1_3_7_63_2","doi-asserted-by":"publisher","DOI":"10.3390\/s21020479"},{"key":"e_1_3_7_64_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241292363"},{"key":"e_1_3_7_65_2","doi-asserted-by":"publisher","DOI":"10.5114\/pedm.2024.146685"}],"container-title":["Diabetes Technology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15209156251390825","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15209156251390825","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15209156251390825","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:10:44Z","timestamp":1787310644000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15209156251390825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":64,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"alternative-id":["10.1177\/15209156251390825"],"URL":"https:\/\/doi.org\/10.1177\/15209156251390825","relation":{},"ISSN":["1520-9156","1557-8593"],"issn-type":[{"value":"1520-9156","type":"print"},{"value":"1557-8593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]}}}