{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:37:20Z","timestamp":1789094240845,"version":"build-2803163510"},"reference-count":44,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T00:00:00Z","timestamp":1583107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Insulin delivery methods, glucose-monitoring modalities, and related outcomes were examined in a large, international, diverse cohort of children and adolescents with type 1 diabetes from the Better Control in Pediatric and Adolescent Diabetes: Working to Create Centers of Reference (SWEET) -Registry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Participants with type 1 diabetes of \u22651 year, aged \u226418 years, and who had documented pump or sensor usage during the period August 2017\u2013July 2019 were stratified into four categories: injections\u2013no sensor (referent); injections + sensor; pump\u2013no sensor; and pump + sensor. HbA1c and proportion of patients with diabetic ketoacidosis (DKA) or severe hypoglycemia (SH) were analyzed; linear and logistic regression models adjusted for demographics, region, and gross domestic product per capita were applied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Data of 25,654 participants were analyzed. The proportions of participants (adjusted HbA1c data) by study group were as follows: injections\u2013no sensor group, 37.44% (8.72; 95% CI 8.68\u20138.75); injections + sensor group, 14.98% (8.30; 95% CI 8.25\u20138.35); pump\u2013no sensor group, 17.22% (8.07; 95% CI 8.03\u20138.12); and pump + sensor group, 30.35% (7.81; 95% CI 7.77\u20137.84). HbA1c was lower in all categories of participants who used a pump and\/or sensor compared with the injections\u2013no sensor treatment method (P &amp;lt; 0.001). The proportion of DKA episodes was lower in participants in the pump + sensor (1.98%; 95% CI 1.64\u20132.48; P &amp;lt; 0.001) and the pump\u2013no sensor (2.02%; 95% CI 1.64\u20132.48; P &amp;lt; 0.05) groups when compared with those in the injections\u2013no sensor group (2.91%; 95% CI 2.59\u20133.31). The proportion of participants experiencing SH was lower in pump\u2013no sensor group (1.10%; 95% CI 0.85\u20131.43; P &amp;lt; 0.001) but higher in the injections + sensor group (4.25%; 95% CI 3.65\u20134.95; P &amp;lt; 0.001) compared with the injections\u2013no sensor group (2.35%; 95% CI 2.04\u20132.71).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Lower HbA1c and fewer DKA episodes were observed in participants using either a pump or continuous glucose monitoring (CGM) or both. Pump use was associated with a lower rate of SH. Across SWEET centers, use of pumps and CGM is increasing. The concomitant use of pump and CGM was associated with an additive benefit.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc20-1674","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T18:35:14Z","timestamp":1614710114000},"page":"1176-1184","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":117,"title":["Glycemic Outcome Associated With Insulin Pump and Glucose Sensor Use in Children and Adolescents With Type 1 Diabetes. Data From the International Pediatric Registry SWEET"],"prefix":"10.2337","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-1657","authenticated-orcid":false,"given":"Roque","family":"Cardona-Hernandez","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology, Hospital Sant Joan de D\u00e9u, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3041-0759","authenticated-orcid":false,"given":"Anke","family":"Schwandt","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Zentralinstitut fuer Biomedizinische Technik, Ulm University, Ulm, Germany"},{"name":"German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hessa","family":"Alkandari","sequence":"additional","affiliation":[{"name":"Dasman Diabetes Institute, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5062-3271","authenticated-orcid":false,"given":"Heiko","family":"Bratke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Haugesund Hospital, Fonna Health Trust, Haugesund, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9622-4433","authenticated-orcid":false,"given":"Agata","family":"Chobot","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Institute of Medical Sciences, University of Opole, Opole, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Coles","sequence":"additional","affiliation":[{"name":"Markham Stouffville Hospital, Markham, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7019-278X","authenticated-orcid":false,"given":"Sarah","family":"Corathers","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damla","family":"Goksen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pediatric Endocrinology and Diabetes, Ege University, \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Goss","sequence":"additional","affiliation":[{"name":"Team Diabetes, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zineb","family":"Imane","sequence":"additional","affiliation":[{"name":"Division of Pediatric Diabetology, Children\u2019s Hospital of Rabat, Mohammed V University, Rabat, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6489-9068","authenticated-orcid":false,"given":"Katrin","family":"Nagl","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.P.","family":"O\u2019Riordan","sequence":"additional","affiliation":[{"name":"The Department of Paediatrics and Endocrinology, Cork University Hospital, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Jefferies","sequence":"additional","affiliation":[{"name":"Starship Children\u2019s Health, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2022031309521026600_B1","doi-asserted-by":"crossref","unstructured":"Nathan\u2008DM, Genuth\u2008S, Lachin\u2008J, et al.; Diabetes Control and Complications Trial Research Group. 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