{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:07:48Z","timestamp":1784635668328,"version":"3.55.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100011946","name":"abbott diabetes care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011946","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ascensia Diabetes Care"},{"DOI":"10.13039\/100015769","name":"dexcom","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014592","name":"Insulet","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100014592","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004374","name":"medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017012","name":"roche diabetes care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017012","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ypsomed Diabetes Care"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Automated insulin delivery (AID) systems improve glycemic control and reduce treatment burden in people with type 1 diabetes, yet their uptake remains suboptimal in many countries. Understanding barriers to the usage of AID systems from the health care professional (HCP) perspective is essential to support wider adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Physicians and diabetes educators\/nurses were invited to complete an online survey assessing the current use of diabetes technology as well as attitudes and barriers to AID and insulin pump therapy. The survey was conducted from October to December 2022. A network analysis was conducted to analyze the associations between different barriers to usage of AID systems and insulin pumps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Data from 594 HCPs (220 physicians and 374 diabetes educators\/nurses) were analyzed. In 2022, HCPs estimated that 11% of their patients with type 1 diabetes used an AID system. They reported that 20% to 27% of eligible patients refuse to use an AID system; 5% to 7% of the users of an AID system stopped using it. The majority of HCPs (68.4% and 60.7%) reported an increased need for education. The most important barriers to start using an AID system were a lack of training and education materials, body image issues, overload, and insufficient training of the members of the diabetes team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There was a sharp increase in AID use in Germany from 2019 to 2022. The results highlight the need for adequate training materials for people with diabetes and the diabetes team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19322968261442286","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T01:12:41Z","timestamp":1778202761000},"page":"1080-1090","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Attitudes and Barriers Toward Automated Insulin Delivery Systems Among Health Care Providers in Germany: A Network Analysis From the dt-Report"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5794-5596","authenticated-orcid":false,"given":"Dominic","family":"Ehrmann","sequence":"first","affiliation":[{"name":"Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany"},{"name":"Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany"},{"name":"Diateam, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6296-947X","authenticated-orcid":false,"given":"Timm","family":"Roos","sequence":"additional","affiliation":[{"name":"Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Kr\u00f6ger","sequence":"additional","affiliation":[{"name":"Center of digital Diabetology Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansj\u00f6rg","family":"M\u00fchlen","sequence":"additional","affiliation":[{"name":"Diabetologikum Duisburg, Duisburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"Keuthage","sequence":"additional","affiliation":[{"name":"Schwerpunktpraxis f\u00fcr Diabetes und Ern\u00e4hrungsmedizin, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Lueg","sequence":"additional","affiliation":[{"name":"Diabeteszentrum L1 Hameln, Hameln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"Scheper","sequence":"additional","affiliation":[{"name":"Diabetes practice Marl, Marl, 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, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1123-1922","authenticated-orcid":false,"given":"Derek","family":"Brandt","sequence":"additional","affiliation":[{"name":"Diabetes Center Berne, Bern, 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":"Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany"},{"name":"Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany"},{"name":"Diateam, Bad Mergentheim, Germany"},{"name":"Diabetes Clinic Mergentheim, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-6352","authenticated-orcid":false,"given":"Maria Luisa","family":"Balmer","sequence":"additional","affiliation":[{"name":"Diabetes Center Berne, Bern, Switzerland"},{"name":"Institute for infectious Diseases, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9970-2162","authenticated-orcid":false,"given":"Jos\u00e9","family":"Garcia-Tirado","sequence":"additional","affiliation":[{"name":"Diabetes Center Berne, Bern, Switzerland"},{"name":"Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9120-4479","authenticated-orcid":false,"given":"Bernhard","family":"Kulzer","sequence":"additional","affiliation":[{"name":"Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany"},{"name":"Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany"},{"name":"Diateam, Bad Mergentheim, Germany"},{"name":"Diabetes Clinic Mergentheim, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"7. 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