{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:35:19Z","timestamp":1777908919665,"version":"3.51.4"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>The usefulness, effectiveness, and safety of advanced hybrid closed-loop systems (AHCLs) in early-stage 3 type 1 diabetes (T1D) are unknown. We report 9 months of continuous glucose monitoring (CGM) outcomes in a patient with early-stage 3 T1D treated with the Tandem t:slim Control-IQ<jats:sup>\u00ae<\/jats:sup> system. A 13-year-old girl, affected by celiac disease and Hashimoto\u2019s thyroiditis, was diagnosed with T1D without symptoms (fasting c-peptide: 1.77 ng\/ml; HbA1c: 6.4%) following an outpatient T1D screening program. She wore a CGM at diagnosis to closely monitor her glucose profile. After 6 months, when the time in range (TIR) fell below 80%, the Tandem t:slim Control-IQ<jats:sup>\u00ae<\/jats:sup> was initiated. Standardized CGM metrics, as well as instances of severe hypoglycemia and diabetic ketoacidosis (DKA), were recorded. CGM data guided the initiation of early insulin therapy. Tandem t:slim Control-IQ<jats:sup>\u00ae<\/jats:sup> system proved effective from the onset of T1D, with a low insulin requirement (0.1 U\/kg\/day, &amp;lt; 10 units\/day) and maintained good metabolic control (TIR &amp;gt; 80%) without severe hypoglycemia or DKA. Based on our experience, we suggest a two-step approach for monitoring and treating patients with early stage 3 type 1 diabetes: first, positioning CGM, and second, when TIR falls below 80%, considering the addition of an AHCLs, even if the patient has a low insulin requirement.<\/jats:p>","DOI":"10.3389\/fendo.2025.1598264","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T05:22:19Z","timestamp":1748928139000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Usefulness, effectiveness, and safety of an advanced hybrid closed-loop system in a child with early identification of type 1 diabetes"],"prefix":"10.3389","volume":"16","author":[{"given":"Chiara","family":"Mameli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maddalena","family":"Macedoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Redaelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnese","family":"Petitti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelina","family":"Hajro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Bosetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianvincenzo","family":"Zuccotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00101-3","article-title":"Effect of population-wide screening for presymptomatic early-stage type 1 diabetes on paediatric clinical care","volume":"12","author":"Bonifiacio","year":"2024","journal-title":"Lancet Diabtes Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"101067","DOI":"10.1016\/j.eclinm.2021.101067","article-title":"Type 1 diabetes onset in Lombardy region, Italy, during the COVID-19 pandemic: The double-wave occurrence","volume":"39","author":"Mameli","year":"2021","journal-title":"EClinicalMedicine"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-0504","article-title":"Automated insulin delivery systems in children and adolescents with type 1 diabetes: A systematic review and meta-analysis of outpatient randomized controlled trials","volume":"46","author":"Zeng","year":"2023","journal-title":"Diabetes Care"},{"key":"B4","article-title":"Legge 15 settembre 2023, n.130","volume-title":"GU Serie Generale n. 226","year":"2023"},{"key":"B5","doi-asserted-by":"publisher","first-page":"907","DOI":"10.3390\/children11080907","article-title":"Passanisi S exploring the continuous glucose monitoring in pediatric diabetes: current practices, innovative metrics, and future implications","volume":"11","author":"Chobot","year":"2024","journal-title":"Children (Basel)."},{"key":"B6","doi-asserted-by":"crossref","DOI":"10.1159\/000543034","article-title":"International society for pediatric and adolescent diabetes clinical practice consensus guidelines 2024: diabetes technologies \u2013 insulin delivery","volume":"97","author":"Biester T","year":"2024","journal-title":"Horm Res Paediatr"},{"key":"B7","article-title":"Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes","volume":"47","author":"Phillip","year":"2024","journal-title":"Diabetes Care"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S003","article-title":"Prevention or delay of diabetes and associated comorbidities: standards of care in diabetes-2025","volume":"48","year":"2025","journal-title":"Diabetes Care"},{"key":"B9","doi-asserted-by":"publisher","first-page":"106792","DOI":"10.1016\/j.phrs.2023.106792","article-title":"Lessons and gaps in the prediction and prevention of type 1 diabetes","volume":"193","author":"Mameli","year":"2023","journal-title":"Pharmacol Res"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12996","article-title":"Changing costs of type 1 diabetes care among US children and adolescents","volume":"21","author":"Crossen","year":"2020","journal-title":". 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