{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T09:05:09Z","timestamp":1792919109056,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001067","name":"Juvenile Diabetes Research Foundation Australia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001067","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001505","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":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Current automated insulin delivery (AID) systems recommend manual insulin delivery prior to meals (hybrid closed-loop [HCL]). Data are needed on the efficacy of an AID system without meal announcement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>In this randomized, open-label, parallel-arm trial, we established participants with type 1 diabetes aged 18\u201370 years on an open-source AID system, with meal announcement, during a 12-week run-in phase, followed by a 12-week trial phase with assignment in a 1:1 ratio to AID without meal announcement or HCL (continued meal announcement). The primary outcome was the percentage of time in the target glucose range of 70\u2013180 mg\/dL (3.9\u201310.0 mmol\/L) in the final 14 days of the trial phase, adjusted for the same metric in the final 14 days of the run-in phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 73 participants underwent randomization (36 to AID without meal announcement and 37 to HCL). Mean (\u00b1standard deviation) time in the target range at the end of the run-in and trial phases was 69 \u00b1 11% and 66 \u00b1 8% in the AID without meal announcement and 70 \u00b1 9% and 69 \u00b1 13% in the HCL group (adjusted difference, \u22122.2 percentage points; 95% confidence interval: \u22126.2 to 1.7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In adults with type 1 diabetes, use of an open-source AID system without meal announcement demonstrated glycemic efficacy and achieved a similar time in the target glucose range to use of the same system as HCL.<\/jats:p>\n                  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