{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T07:28:13Z","timestamp":1793518093911,"version":"4.5.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Helmsley Charitable Trust funds the T1D Exchange Q.I. collaborative.","id":[{"id":"https:\/\/ror.org\/016jvas21","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Use of automated insulin delivery (AID) systems has increased in people with type 1 diabetes (T1D); however, real-world data in preschool-age children remain limited. In this multicenter analysis, we assess real-world glycemic outcomes in preschool-age children using AID systems compared with those using multiple daily injections (MDIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective, multicenter, cross-sectional analysis assessed current usage of AID systems and glycemic outcomes in preschool-age children \u22646 years across 37 pediatric sites in the T1D Exchange Quality Improvement Collaborative (T1DX-QI). Differences in AID use and HbA1c were evaluated using\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      tests and \u03c7\u00b2 tests, with multivariable logistic and linear regression models adjusting for age, race\/ethnicity, diabetes duration and insurance type to assess associations between AID use and glycemic outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In this cohort of 3521 youth \u22646 years, the mean age was 4.6 (1.4), 47% female, 53% non-Hispanic white, 12% non-Hispanic black, and 14% Hispanic, and 31% with public insurance. Of these, 48% were using AID for insulin management with a mean HbA1c of 7.9% (1.7), compared with 52% using MDI with a mean HbA1c of 8.8% (2.2),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001. In this cohort, 25% had an HbA1c &lt;7%. AID use was associated with a greater odds of achieving HbA1c &lt;7% (OR 1.91, 95% CI 1.57 to 2.33,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Real-world use of AID systems in preschool-age children (\u22646 years of age) is associated with lower A1c levels and greater potential to achieve the American Diabetes Association (ADA) A1c target range of &lt;7%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19322968261459450","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:31:08Z","timestamp":1782235868000},"page":"1757-1762","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Automated Insulin Delivery Use Among Preschool-Age Children With Type 1 Diabetes: A T1D Exchange Multicenter Analysis"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7674-520X","authenticated-orcid":false,"given":"Risa M.","family":"Wolf","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology, Johns Hopkins Medicine, Baltimore, MD, USA"},{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4723-001X","authenticated-orcid":false,"given":"Emma","family":"Ospelt","sequence":"additional","affiliation":[{"name":"T1D Exchange, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruvi","family":"Vora","sequence":"additional","affiliation":[{"name":"T1D Exchange, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ori","family":"Odugbesan","sequence":"additional","affiliation":[{"name":"T1D Exchange, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Johns Hopkins Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0573-6650","authenticated-orcid":false,"given":"Jenise C.","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, University of California San Francisco, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5141-0427","authenticated-orcid":false,"given":"Christine A.","family":"March","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, UPMC Children\u2019s Hospital of Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0210-655X","authenticated-orcid":false,"given":"Nestoras","family":"Mathioudakis","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins Medicine, Baltimore, MD, 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