{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:35:57Z","timestamp":1793320557592,"version":"4.5.0"},"reference-count":81,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"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\/100019063","name":"Tandem Diabetes Care","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019063","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Rubin Medical AB"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Automated insulin delivery (AID) systems integrate continuous glucose monitoring (CGM) and insulin pumps with algorithms that adjust insulin delivery. While randomized controlled trials (RCTs) demonstrate improvements in glycemic outcomes with AID, large-scale real-world data (RWD) analyses are needed to evaluate performance in routine care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective, registry-based cohort study included adults (\u226518 years) with type 1 diabetes (T1D) in the Swedish National Diabetes Register (NDR) from 2014 to 2024. Hemoglobin (Hb)A1c values were averaged per person-year and aggregated by clinic. Insulin delivery\/glucose monitoring combinations included multiple daily injections (MDIs) with blood glucose meter (MDI-BG), MDI with CGM (MDI-CGM, reference), conventional continuous subcutaneous insulin infusion with blood glucose meter (CSII-BG), CSII with CGM (CSII-CGM), and AID systems (Tandem Control-IQ technology, Medtronic 670G, and Medtronic 780G). Mixed-model regression assessed HbA1c outcomes, with treatment, year, age, diabetes duration, gender, body mass index, physical activity level, smoking habits, and clinic size as fixed effects; with random effects for clinics; and weighting by clinic sample size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After adjusting for the covariates, AID systems were associated with significantly lower HbA1c compared with MDI-CGM:\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22124.0 mmol\/mol (95% confidence interval [CI] \u22124.3 to \u22123.7,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), with individual system effects, Tandem Control-IQ technology\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22124.8 mmol\/mol (95% CI \u22125.2 to \u22124.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), Medtronic 780G\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22123.1 (\u22123.5 to \u22122.7,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and Medtronic 670G\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22122.9 (95% CI \u22123.5 to \u22122.4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). CSII-CGM also outperformed MDI-CGM:\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22121.7 mmol\/mol (95% CI \u22121.9 to \u22121.4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Differences between the Tandem and Medtronic AID systems were significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In a nationwide RWD analysis, AID use was consistently associated with clinically and statistically significant HbA1c reductions in adults with T1D, with the greatest effect for Tandem Control-IQ technology. These findings align with RCTs and international RWD, supporting AID as a preferred technology in routine diabetes care for T1D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15209156251414976","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:44:35Z","timestamp":1769165075000},"page":"808-820","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Automated Insulin Delivery Associated with Superior Glycemic Outcomes in Type 1 Diabetes: A Swedish National Registry Analysis"],"prefix":"10.1177","volume":"28","author":[{"given":"Fredrik","family":"St\u00e5hl","sequence":"first","affiliation":[{"name":"SmartStep Nordics AB, Helsingborg, Sweden."},{"name":"Current affiliation: Agnostic Technology AB, Limhamn, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarl","family":"Hellman","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ekelund","sequence":"additional","affiliation":[{"name":"Rubin Medical AB, Malm\u00f6, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-019-01326-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13793"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816650209"},{"key":"e_1_3_3_5_2","article-title":"Diabetes Technology: Standards of Care in Diabetes\u20142025","volume":"48","author":"American Diabetes Association","year":"2025","unstructured":"American Diabetes Association. Diabetes Technology: Standards of Care in Diabetes\u20142025. Diabetes Care, 2025; 48.","journal-title":"Diabetes Care"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-020-01589-3"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.324"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05568-3"},{"issue":"3","key":"e_1_3_3_9_2","first-page":"783","article-title":"Automated Insulin Delivery (AID) systems: Use and efficacy in children and adults with type 1 diabetes and other forms of diabetes in Europe in Early 2023","volume":"13","author":"Bassi M","year":"2023","unstructured":"Bassi M, , Franzone D, , Dufour F, et al. Automated Insulin Delivery (AID) systems: Use and efficacy in children and adults with type 1 diabetes and other forms of diabetes in Europe in Early 2023. Life (Basel), 2023; 13(3):783.","journal-title":"Life (Basel)"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31947-0"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00212-1"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1447"},{"key":"e_1_3_3_13_2","first-page":"367","article-title":"Safety and glycemic outcomes during the MiniMed 670G pivotal trial","volume":"23","author":"Carlson AL","year":"2021","unstructured":"Carlson AL, , Nimri R, , Weinzimer SA, et al. Safety and glycemic outcomes during the MiniMed 670G pivotal trial. Diabetes Technol Ther, 2021; 23:367\u2013376.","journal-title":"Diabetes Technol Ther"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1907863"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(19)30003-2"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-1550"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0206"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-025-06366-x"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0453"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0433"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15008"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231185348"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0578"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1674"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0442"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-023-01394-5"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2024.0130"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103190"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3842"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnac022"},{"key":"e_1_3_3_31_2","unstructured":"Diabetes Australia. AID Access Summit Consensus Statement. 2023. Available from: https:\/\/www.diabetesaustralia.com.au\/wp-content\/uploads\/AID-Access-Summit-Consensus-Statement_FINAL.pdf [Last accessed: December7 2025]."},{"key":"e_1_3_3_32_2","unstructured":"National Institute for Health Excellence C. Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes: Technology appraisal TA943."},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3310\/JYPL3536"},{"key":"e_1_3_3_34_2","unstructured":"Swedish National Diabetes Register. The Swedish National Diabetes Register \u2013 in English. 2025. Available from: https:\/\/ndr.registercentrum.se\/in-english\/the-swedish-national-diabetes-register\/p\/BJyILnupj [Last accessed: December7 2025]."},{"issue":"3","key":"e_1_3_3_35_2","first-page":"1","article-title":"Mice: Multivariate imputation by chained equations in R","volume":"45","author":"van Buuren S","year":"2011","unstructured":"van Buuren S, , Groothuis-Oudshoorn K. Mice: Multivariate imputation by chained equations in R. J Stat Soft, 2011; 45(3):1\u201367.","journal-title":"J Stat Soft"},{"key":"e_1_3_3_36_2","volume-title":"Survey Sampling","author":"Kish L","year":"1965","unstructured":"Kish L. Survey Sampling. Wiley: London; 1965."},{"key":"e_1_3_3_37_2","unstructured":"R Core Team. R: A language and environment for statistical computing. 2021. Available from: https:\/\/www.R-project.org\/"},{"key":"e_1_3_3_38_2","unstructured":"Folkh\u00e4lsomyndigheten. Levnadsvanor \u2013 Resultat f\u00f6r uppf\u00f6ljningen av folkh\u00e4lsopolitikens m\u00e5lomr\u00e5de 6. 2025. Available from: https:\/\/www.folkhalsomyndigheten.se\/publikationer-och-material\/publikationsarkiv\/l\/levnadsvanor-malomrade-6\/ [Last accessed: December7 2025]."},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2012.0286"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-0888"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19975"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19976"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1468"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15718"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-023-01144-4"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241290259"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2311"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32514-9"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0421"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16485"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.766314"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.70043"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-024-01946-w"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15344"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.3389\/FENDO.2023.1283181"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16234"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968251315459"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-0129"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00319-9"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-1355"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241242386"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2022.03.031"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.2337\/ds23-0057"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2500173"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25041972"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0162960"},{"key":"e_1_3_3_67_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14766"},{"key":"e_1_3_3_68_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2022.104259"},{"key":"e_1_3_3_69_2","doi-asserted-by":"publisher","DOI":"10.3390\/diabetology3020027"},{"key":"e_1_3_3_70_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0030"},{"key":"e_1_3_3_71_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15415"},{"key":"e_1_3_3_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2022.101370"},{"key":"e_1_3_3_73_2","unstructured":"The Swedish Council for Information on Alcohol Drugs O. Socioekonomiska skillnader i beroende och utsatthet f\u00f6r andras anv\u00e4ndning av alkohol narkotika och tobak. Rapport CAN\/176. 2025. Available from: https:\/\/www.can.se\/publikationer\/socioekonomiska-skillnader-i-beroende-och-utsatthet-for-andras-anvandning-av-alkohol-narkotika-och-tobak\/ [Last accessed: December7 2025]."},{"key":"e_1_3_3_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2012.12.025"},{"key":"e_1_3_3_75_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13175303"},{"key":"e_1_3_3_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.endinu.2024.02.005"},{"key":"e_1_3_3_77_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0389"},{"key":"e_1_3_3_78_2","doi-asserted-by":"publisher","DOI":"10.1007\/S40200-025-01718-1"},{"key":"e_1_3_3_79_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-024-03573-x"},{"key":"e_1_3_3_80_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-1137"},{"key":"e_1_3_3_81_2","unstructured":"Food and Drug Administration\/U.S. Department of Health and Human. Guidance for Industry and Food. Food and Drug Administration; 2015 7."},{"key":"e_1_3_3_82_2","unstructured":"European Medicines Agency. Guideline on clinical investigation of medicinal products in the treatment or prevention of diabetes mellitus (Revision 2). 2018. Available from: https:\/\/www.ema.europa.eu\/en\/clinical-investigation-medicinal-products-treatment-or-prevention-diabetes-mellitus-scientific-guideline [Last accessed: December7 2025]."}],"updated-by":[{"DOI":"10.1177\/15209156261424183","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000}}],"container-title":["Diabetes Technology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15209156251414976","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15209156251414976","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15209156251414976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:10:22Z","timestamp":1787310622000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15209156251414976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":81,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1177\/15209156251414976"],"URL":"https:\/\/doi.org\/10.1177\/15209156251414976","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]]}}}