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Evidence for the efficacy of using systems for continuous glucose monitoring, automated insulin delivery, and so on has largely been derived from randomized controlled trials, which are pivotal for regulatory approvals and reimbursement decisions. However, evidence obtained from real-world usage of technology is crucial as it confirms the benefits also under such conditions. Data obtained from a detailed survey answered by health care professionals and people living with diabetes provides further insights into the reality of usage. They also help to understand the hurdles in daily life and what can be done to overcome these. In this special theme issue, a set of specific topics is addressed that are of academic and clinical importance: dropouts from automated insulin delivery systems, technology use in people living with type 2 diabetes, technology and aging, smart insulin pens, and green diabetes. The data basis for the analysis presented in these manuscripts is from Germany, Austria, and Switzerland. In the future, data from other European Countries will complement the insights gained. This will help to understand the similarities and differences between these countries, which have specific differences in their health care systems. This can lead to subsequent activities in the different countries to improve the clinical care of people living with diabetes.<\/jats:p>","DOI":"10.1177\/19322968261436830","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T04:54:19Z","timestamp":1775278459000},"page":"1066-1069","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The dt-Report: A Novel Real-World Data Approach to Understanding the Use and Impact of Diabetes Technology in European Countries"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1123-1922","authenticated-orcid":false,"given":"Derek","family":"Brandt","sequence":"first","affiliation":[{"name":"Diabetes Center Berne, Berne, Switzerland"},{"name":"Serpentine Ventures, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-2677","authenticated-orcid":false,"given":"Norbert","family":"Hermanns","sequence":"additional","affiliation":[{"name":"diateam GmbH, Bad Mergentheim, Germany"},{"name":"FIDAM GmbH, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-5596","authenticated-orcid":false,"given":"Dominic","family":"Ehrmann","sequence":"additional","affiliation":[{"name":"diateam GmbH, Bad Mergentheim, Germany"},{"name":"FIDAM GmbH, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9120-4479","authenticated-orcid":false,"given":"Bernhard","family":"Kulzer","sequence":"additional","affiliation":[{"name":"diateam GmbH, Bad Mergentheim, Germany"},{"name":"FIDAM GmbH, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-9880","authenticated-orcid":false,"given":"Peter","family":"Diem","sequence":"additional","affiliation":[{"name":"Endokrinologie Diabetologie Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0221-0901","authenticated-orcid":false,"given":"Javier","family":"Ampudia-Blasco","sequence":"additional","affiliation":[{"name":"Endocrinology &amp; Nutrition Department, Clinic University Hospital Valencia, and Medicine Department, University of Valencia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-4233","authenticated-orcid":false,"given":"Julia K.","family":"Mader","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Faber-Heinemann","sequence":"additional","affiliation":[{"name":"diateam GmbH, Bad Mergentheim, Germany"},{"name":"Science Consulting in Diabetes GmbH, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2493-1304","authenticated-orcid":false,"given":"Lutz","family":"Heinemann","sequence":"additional","affiliation":[{"name":"diateam GmbH, Bad Mergentheim, Germany"},{"name":"Science Consulting in Diabetes GmbH, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-018-0239-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231170884"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296819839996"},{"key":"e_1_3_2_5_2","unstructured":"Food and Drug Administration. 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