{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:48:17Z","timestamp":1784638097594,"version":"3.55.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI22\/00616"],"award-info":[{"award-number":["PI22\/00616"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To evaluate the impact of automated insulin delivery (AID) systems on the incidence and progression of diabetic retinopathy (DR) in adults with type 1 diabetes (T1D) compared with multiple daily injections (MDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study followed 379 adults with T1D for a mean of 4.9 \u00b1 1.4 years. DR was assessed via standardized retinal imaging. At baseline, 80 participants used AID, and 35 initiated AID during follow-up; 264 remained on MDI. Outcomes included baseline DR prevalence, incident DR, and DR progression. Multivariate Poisson and Cox regression models adjusted for key covariates (age, diabetes duration, pre-baseline HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ) were used, with propensity score-matched and HbA1c trajectory analyses as sensitivity checks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      DR prevalence at baseline was 13.9% with no group differences. Incident DR was lower among AID users (6.1% vs. 18.9% in MDI; hazard ratio = 0.33, 95% confidence interval: 0.13\u20130.73;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01; number needed to treat = 8). DR progression and all vision-threatening events occurred only in the MDI group (41.7% vs. 0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Use of AID systems resulted in a greater reduction in HbA\n                      <jats:sub>1c<\/jats:sub>\n                      compared with MDI (\u22120.32% vs. \u22120.06%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>AID systems were associated with improved glycemic control and reduced incidence and progression of DR in adults with T1D. These findings support AID use to prevent early microvascular complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15209156251411929","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T06:55:38Z","timestamp":1770360938000},"page":"708-716","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Automated Insulin Delivery Reduces the Risk of Diabetic Retinopathy in Adults with Type 1 Diabetes: A Prospective Cohort Study"],"prefix":"10.1177","volume":"28","author":[{"given":"L\u00eda","family":"Nattero-Ch\u00e1vez","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain."},{"name":"Grupo de Investigaci\u00f3n en Diabetes, Obesidad y Reproducci\u00f3n Humana, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, Spain."},{"name":"Universidad de Alcal\u00e1, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"de Lope Qui\u00f1ones","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Diabetes, Obesidad y Reproducci\u00f3n Humana, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, Spain."},{"name":"Universidad de Alcal\u00e1, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Quintero Tobar","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Diabetes, Obesidad y Reproducci\u00f3n Humana, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"de la Calle de la Villa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane","family":"Bayona","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Ruiz Gracia","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor F.","family":"Escobar-Morreale","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain."},{"name":"Grupo de Investigaci\u00f3n en Diabetes, Obesidad y Reproducci\u00f3n Humana, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Luque Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, Madrid, Spain."},{"name":"Grupo de Investigaci\u00f3n en Diabetes, Obesidad y Reproducci\u00f3n Humana, Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, Spain."},{"name":"Universidad de Alcal\u00e1, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci21-0043"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S012"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/db2024-01"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291401"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2251"},{"key":"e_1_3_6_7_2","article-title":"Consensus recommendations for the use of automated insulin delivery (AID) technologies in clinical practice","volume":"6","author":"Phillip M","year":"2022","unstructured":"Phillip M, , Nimri R, , Bergenstal RM, et al. 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