{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:52:31Z","timestamp":1790369551241,"version":"4.1.0"},"reference-count":16,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T00:00:00Z","timestamp":1680739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"NIH\/NIDDK","award":["5T32DK063687-17"],"award-info":[{"award-number":["5T32DK063687-17"]}]},{"name":"NIH\/NIDDK","award":["K12DK094712"],"award-info":[{"award-number":["K12DK094712"]}]},{"name":"NIH\/NIDDK","award":["P30-DK116073"],"award-info":[{"award-number":["P30-DK116073"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>While continuous glucose monitors (CGMs), insulin pumps, and hybrid closed-loop (HCL) systems each improve glycemic control in type 1 diabetes, it is unclear how the use of these technologies impacts real-world pediatric care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We found 1,455 patients aged &amp;lt;22 years, with type 1 diabetes duration &amp;gt;3 months, and who had data from a single center in between both 2016\u20132017 (n = 2,827) and 2020\u20132021 (n = 2,731). Patients were grouped by multiple daily injections or insulin pump, with or without an HCL system, and using a blood glucose monitor or CGM. Glycemic control was compared using linear mixed-effects models adjusting for age, diabetes duration, and race\/ethnicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>CGM use increased from 32.9 to 75.3%, and HCL use increased from 0.3 to 27.9%. Overall A1C decreased from 8.9 to 8.6% (P &amp;lt; 0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc22-2121","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T19:08:28Z","timestamp":1680808108000},"page":"1218-1222","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":29,"title":["Increased Technology Use Associated With Lower A1C in a Large Pediatric Clinical Population"],"prefix":"10.2337","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5676-761X","authenticated-orcid":false,"given":"G. Todd","family":"Alonso","sequence":"first","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor M.","family":"Triolo","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4518-5179","authenticated-orcid":false,"given":"Halis Kaan","family":"Akturk","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan E.","family":"Pauley","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Sobczak","sequence":"additional","affiliation":[{"name":"2School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Forlenza","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pyle","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"},{"name":"3Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6636-4048","authenticated-orcid":false,"given":"Brigitte I.","family":"Frohnert","sequence":"additional","affiliation":[{"name":"1Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,4,6]]},"reference":[{"key":"2023052319011282600_B1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1089\/dia.2018.0161","article-title":"Performance of Medtronic hybrid closed-loop iterations: results from a randomized trial in adolescents with type 1 diabetes","volume":"20","author":"de Bock","year":"2018","journal-title":"Diabetes Technol Ther"},{"key":"2023052319011282600_B2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1089\/dia.2018.0264","article-title":"Safety evaluation of the MiniMed 670G System in children 7\u201313 years of age with type 1 diabetes","volume":"21","author":"Forlenza","year":"2019","journal-title":"Diabetes Technol Ther"},{"key":"2023052319011282600_B3","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1056\/NEJMoa1907863","article-title":"Six-month randomized, multicenter trial of closed-loop control in type 1 diabetes","volume":"381","author":"Brown","year":"2019","journal-title":"N Engl J Med"},{"key":"2023052319011282600_B4","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1056\/NEJMoa2004736","article-title":"A randomized trial of closed-loop control in children with type 1 diabetes","volume":"383","author":"Breton","year":"2020","journal-title":"N Engl J Med"},{"key":"2023052319011282600_B5","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.2337\/dc21-0172","article-title":"Multicenter trial of a tubeless, on-body automated insulin delivery system with customizable glycemic targets in pediatric and adult participants with type 1 diabetes","volume":"44","author":"Brown","year":"2021","journal-title":"Diabetes Care"},{"key":"2023052319011282600_B6","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/pedi.13312","article-title":"Glycemic outcomes of children 2-6\u2009years of age with type 1 diabetes during the pediatric MiniMed\u2122 670G system trial","volume":"23","author":"Forlenza","year":"2022","journal-title":"Pediatr Diabetes"},{"key":"2023052319011282600_B7","unstructured":"U.S. Food and Drug Administration\n          . FDA approves first automated insulin delivery device for type 1 diabetes. 28 September 2016. Accessed 9 December 2022. Available from https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-automated-insulin-delivery-device-type-1-diabetes"},{"key":"2023052319011282600_B8","unstructured":"U.S. Food and Drug Administration\n          . FDA authorizes first interoperable, automated insulin dosing controller designed to allow more choices for patients looking to customize their individual diabetes management device system. 13 December 2019. Accessed 9 December 2022. Available from https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-authorizes-first-interoperable-automated-insulin-dosing-controller-designed-allow-more-choices"},{"key":"2023052319011282600_B9","unstructured":"U.S. Food and Drug Administration\n          . FDA authorizes first fully interoperable continuous glucose monitoring system, streamlines review pathway for similar devices. 27 March 2018. Accessed 9 December 2022. Available from https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-authorizes-first-fully-interoperable-continuous-glucose-monitoring-system-streamlines-review"},{"key":"2023052319011282600_B10","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/pedi.12962","article-title":"Six months of hybrid closed loop in the real-world: an evaluation of children and young adults using the 670G system","volume":"21","author":"Berget","year":"2020","journal-title":"Pediatr Diabetes"},{"key":"2023052319011282600_B11","doi-asserted-by":"crossref","first-page":"e15015","DOI":"10.1111\/dme.15015","article-title":"Real world use of hybrid-closed loop in children and young people with type 1 diabetes mellitus\u2014a National Health Service pilot initiative in England","volume":"40","author":"Ng","year":"2023","journal-title":"Diabet Med"},{"key":"2023052319011282600_B12","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.2337\/dc20-1674","article-title":"Glycemic outcome associated with insulin pump and glucose sensor use in children and adolescents with type 1 diabetes. 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