{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:04:28Z","timestamp":1784621068545,"version":"3.55.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Evidence on the long-term durability of glycemic control beyond the first year of automated insulin delivery therapy remains limited, particularly in large multicenter pediatric cohorts. The present study aimed to evaluate long-term effectiveness and identify determinants of sustained optimal outcomes over 3 years of MiniMed\u2122 780G use in youth with type 1 diabetes (T1D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>In this longitudinal, multicenter, real-world study, 359 youth with T1D (median age 12.2 years, 50.9% female) from 20 Italian pediatric diabetes centers were followed for 3 years after MiniMed 780G initiation. Glucose metrics, insulin delivery parameters, device settings, and engagement indicators were analyzed at 1, 2, and 3 years. Longitudinal changes were assessed using linear mixed-effects models. Multivariable logistic regression identified predictors of achieving time in tight range target (TITR \u2265 50%) at 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Median time in range (TIR) remained within international targets but declined modestly from 75% at 1 year to 74% at 3 years (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). The percentage of automatic correction boluses increased over time, whereas user-initiated boluses and carbohydrate entries declined (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Youth with higher TIR at 1 year showed a progressive reduction in TIR and greater increase in automated corrections (time \u00d7 group interaction\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). At 3 years, higher SmartGuard use (odds ratio [OR]: 1.13, 95% confidence interval [CI]: 1.03\u20131.23;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.007), optimal system settings (OR: 3.21, 95% CI: 1.33\u20137.77;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.010), and lower automatic correction boluses (OR: 0.84, 95% CI: 0.80\u20130.89;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) were independently associated with achieving TITR \u226550%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>MiniMed 780G provides sustained glycemic control over 3 years. However, progressive reliance on automated corrections and reduced user engagement may attenuate tight glycemic control, highlighting the need for ongoing education and proactive device optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15209156261469663","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:00:18Z","timestamp":1784354418000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Three-Year Durability of Automated Insulin Delivery Therapy in Children and Adolescents with Type 1 Diabetes: A Multicenter Real-World Study"],"prefix":"10.1177","author":[{"given":"Bruno","family":"Bombaci","sequence":"first","affiliation":[{"name":"Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi,\u201d University of Messina, Messina, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7081-5884","authenticated-orcid":false,"given":"Fortunato","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi,\u201d University of Messina, Messina, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Bassi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Minuto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Tornese","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy."},{"name":"Institute for Maternal and Child Health IRCCS \u201cBurlo Garofolo,\u201d Trieste, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eulalia","family":"Catamo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS \u201cBurlo Garofolo,\u201d Trieste, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Bonfanti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Diabetology Unit, Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2557-4150","authenticated-orcid":false,"given":"Andrea","family":"Rigamonti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Diabetology Unit, Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Reinstadler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mila A.","family":"Kalapurackal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Mameli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, ASST Fatebenefratelli Sacco, Vittore Buzzi Children\u2019s Hospital, Milan, Italy."},{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianvincenzo","family":"Zuccotti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, ASST Fatebenefratelli Sacco, Vittore Buzzi Children\u2019s Hospital, Milan, Italy."},{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Maffeis","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Piona","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Delvecchio","sequence":"additional","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L\u2019Aquila, L\u2019Aquila, Italy."},{"name":"Department of Metabolic Diseases and Clinical Genetics, Giovanni XXIII Children Hospital, Bari, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Arnaldi","sequence":"additional","affiliation":[{"name":"UOS Diabetologia pediatrica ASL Viterbo, Viterbo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Felappi","sequence":"additional","affiliation":[{"name":"U.S. Auxoendocrinologia pediatrica, U.O.C Pediatria-Clinica Pediatrica, ASST Spedali Civili, Brescia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enza","family":"Mozzillo","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Roppolo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Regional Center for Pediatrics Diabetes. A.R.N.A.S Civico Di Cristina Benfratelli, Palermo, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Maltoni","sequence":"additional","affiliation":[{"name":"Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Lo Presti","sequence":"additional","affiliation":[{"name":"Regional Referral Centre of Pediatric Diabetes, University Hospital \u201cPoliclinico\u201d, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8832-2902","authenticated-orcid":false,"given":"Giulia","family":"Pezzino","sequence":"additional","affiliation":[{"name":"Maternal and Child Health Department, Paediatric Diabetology Unit, Garibaldi Hospital, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Zanfardino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Regional Center of Pediatric Diabetology \u201cG.Stoppoloni\u201d, University of Campania \u201cLuigi Vanvitelli\u201d, Naples, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Salzano","sequence":"additional","affiliation":[{"name":"Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi,\u201d University of Messina, Messina, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Passanisi","sequence":"additional","affiliation":[{"name":"Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi,\u201d University of Messina, Messina, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ISPED Diabetes Group Study Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000543034"},{"issue":"1","key":"e_1_3_2_3_1","first-page":"S150","article-title":"7. 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