{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:52:24Z","timestamp":1792788744491,"version":"4.5.0"},"reference-count":0,"publisher":"American Diabetes Association","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"The Foundation for Growth Science","id":[{"id":"https:\/\/ror.org\/05hnjz787","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004053","name":"Masato Kawano Memorial Public Interest Foundation for Promotion of Pediatrics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JSPS KAKENHI Grant Numbers JP17K01867"],"award-info":[{"award-number":["JSPS KAKENHI Grant Numbers JP17K01867"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JSPS KAKENHI Grant Numbers JP19K10618"],"award-info":[{"award-number":["JSPS KAKENHI Grant Numbers JP19K10618"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JSPS KAKENHI Grant Numbers JP20K11653"],"award-info":[{"award-number":["JSPS KAKENHI Grant Numbers JP20K11653"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JSPS KAKENHI Grant Numbers JP25K13628"],"award-info":[{"award-number":["JSPS KAKENHI Grant Numbers JP25K13628"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Japan Diabetes Foundation","award":["research grants"],"award-info":[{"award-number":["research grants"]}],"id":[{"id":"https:\/\/ror.org\/002cfy541","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["Health Labour Sciences Research Grant 23FA1020"],"award-info":[{"award-number":["Health Labour Sciences Research Grant 23FA1020"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["independent educational grant"],"award-info":[{"award-number":["independent educational grant"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Type 1 diabetes (T1D) management in children requires a comprehensive approach tailored to developmental stages and school environments. This study investigated the locations of self-management behaviors at school, examining factors influencing location choice and their associations with glycemic control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This multicenter, cross-sectional study analyzed 2018 registration data from 1,105 children with T1D attending schools or preschools in Japan. Associations among HbA1c, care behaviors, locations, treatment modalities, age, and sex were statistically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The mean (SD) HbA1c was 8.01% (1.12%) (64.0 [12.2] mmol\/mol). Care locations were the classroom (36.9%), designated rooms (52.6%), and the restroom (5.9%). HbA1c was significantly higher in the restroom group at 8.56% (0.98%) (70.1 [10.7] mmol\/mol) than in the classroom group at 8.00% (1.20%) (63.9 [13.1] mmol\/mol) and designated room group at 7.95% (1.08%) (63.4 [11.8] mmol\/mol) (P &amp;lt; 0.001). Restroom use and omitting prelunch blood glucose monitoring were independently associated with higher HbA1c. Pump use, continuous glucose monitoring, and male sex predicted higher classroom use and lower restroom use. Joinpoint analysis showed that classroom use declined after age 6 (elementary school entry), whereas restroom use emerged from age 11 and spiked markedly at age 16 (20.8%), coinciding with high school entry, even among pump users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Care location choice shifts dynamically with age and school transitions, with restroom use being linked to poorer glycemic control. Supporting youth during school transitions requires targeted environmental adjustments and enhanced school-wide understanding to ensure safe and appropriate care locations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc26-1452","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:40:37Z","timestamp":1792006837000},"update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Diabetes Care of Children With Type 1 Diabetes at School: Factors Related to the Choice of Care Location and Association With Glycemic Control"],"prefix":"10.2337","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3350-8316","authenticated-orcid":false,"given":"Katsuyuki","family":"Matsui","sequence":"first","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"2Division of Pediatric Endocrinology, Metabolism and Diabetes, Shiga General Hospital, Moriyama, Shiga, Japan"},{"name":"3Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Nemoto","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"2Division of Pediatric Endocrinology, Metabolism and Diabetes, Shiga General Hospital, Moriyama, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Tagawa","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"3Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizuyo","family":"Nagai","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"3Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Fukawa","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"4Department of Pediatrics, Tokyo Women\u2019s Medical University Yachiyo Medical Center, Yachiyo, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Matsuura","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"5Department of Pediatrics, Japanese Red Cross Suwa Hospital, Suwa, Nagano, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Shiga","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"6Children\u2019s Medical Center, Yokohama City University Medical Center, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7976-9557","authenticated-orcid":false,"given":"Tatsuhiko","family":"Urakami","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"7Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Kawamura","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"8Department of Pediatrics, Osaka City University School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeyuki","family":"Ohtsu","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"9Nakanoshima Diabetes Clinic, Kawasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"1The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto, Japan"},{"name":"10Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Moroyama, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,10,7]]},"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc26-1452\/897888\/dc261452.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc26-1452\/897888\/dc261452.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:40:39Z","timestamp":1792006839000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/doi\/10.2337\/dc26-1452\/172733\/Diabetes-Care-of-Children-With-Type-1-Diabetes-at"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2337\/dc26-1452","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"dc261452"}}