{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T14:32:58Z","timestamp":1776954778101,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Consejer\u00eda de Salud y Familia de la Junta de Andaluc\u00eda","award":["PIGE-0533-2019"],"award-info":[{"award-number":["PIGE-0533-2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Type 1 diabetes mellitus (T1D) is the most common metabolic disorder in children, with significant physical and emotional impacts. Achieving optimal glucometric control is challenging due to the complex management and limitations of insulin therapy. Advances in pharmacology and technology, including continuous glucose monitoring (CGM) systems, offer new options for diabetes management. We developed Andiacare, an open-source platform for macro\/micro-management of diabetes and analyzed its application in a pediatric T1D cohort to evaluate glucometric control patterns. Methods: A retrospective cohort study was conducted in a pediatric population (&lt;18 years old) in Andalusia, Spain. Patients treated with Multiple Daily Injections of Insulin (MDI) and FreeStyle Libre 2 System (Abbott, Spain) were included. The patient data were analyzed using the Andiacare platform, which categorizes patients based on the Advanced Technologies and Treatments for Diabetes (ATTD) panel\u2019s targets for glucometric control. Results: The study included 2215 patients from 18 pediatric hospitals. The Andiacare platform categorized patients into four groups based on glucometric control parameters, enabling patient stratification based on their glucometric control. Only 25.8% of the cohort achieved the recommended Time in Range (TIR), and 9.5% of the patients achieved all target parameters of glucometric control. Age is a determinant factor in adherence and achievement of set goals. Conclusions: This study offers insights into glucometric control in a large pediatric population with T1D in Andalusia. Few patients achieved the recommended glucometric control targets, highlighting the need for improved management strategies. The use of digital platforms such as Andiacare might contribute to facilitating the management of large pediatric cohorts. New algorithms integrating glucometric and non-glucometric parameters are required for improved individual and cohort categorization to optimize therapeutic interventions.<\/jats:p>","DOI":"10.3390\/jcm14176243","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T09:18:57Z","timestamp":1756977537000},"page":"6243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glycemic Analysis and Stratification of Pediatric Patients with Type 1 Diabetes Using isCGM in Southern Spain: Insights from the Andiacare Digital Platform"],"prefix":"10.3390","volume":"14","author":[{"given":"Isabel","family":"Leiva-Gea","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology, Regional University Hospital of M\u00e1laga, 29011 M\u00e1laga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)-Plataforma BIONAND, 29010 M\u00e1laga, Spain"},{"name":"Department of Biomedicine and Dentistry, Faculty of Biomedical Sciences and Sports, Universidad Europea de Andaluc\u00eda, 29010 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7498-1962","authenticated-orcid":false,"given":"Fernando","family":"Moreno-Jabato","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)-Plataforma BIONAND, 29010 M\u00e1laga, Spain"},{"name":"PACAL Care Systems, 29006 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Bel\u00e9n","family":"Ariza-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology Service, Reina Sof\u00eda University Hospital, Avda. Menendez Pidal, s\/n, 14004 C\u00f3rdoba, Spain"},{"name":"Growth Study Group, Pediatric Endocrinology and Nutrition, Maimonides Institute of Biomedical Research of Cordoba, Av. Menendez Pidal, s\/n, 14004 C\u00f3rdoba, Spain"},{"name":"Faculty of Medicine and Nursing, University of Cordoba, Avda. Menendez Pidal, 7, 14004 C\u00f3rdoba, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4408-1335","authenticated-orcid":false,"given":"Alfonso","family":"Lend\u00ednez-Jurado","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regional University Hospital of M\u00e1laga, 29011 M\u00e1laga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)-Plataforma BIONAND, 29010 M\u00e1laga, Spain"},{"name":"Distrito Sanitario M\u00e1laga-Guadalhorce, 29009 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2478-4212","authenticated-orcid":false,"given":"Ana","family":"G\u00f3mez-Perea","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regional University Hospital of M\u00e1laga, 29011 M\u00e1laga, Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga (IBIMA)-Plataforma BIONAND, 29010 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Mar","family":"Romero-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Virgen Macarena University Hospital, 41009 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-4086","authenticated-orcid":false,"given":"Emilio","family":"Garc\u00eda-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Virgen del Roc\u00edo University Hospital, 41013 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda \u00c1ngeles","family":"Santos Mata","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, University Hospital of Jerez de la Frontera, 11407 C\u00e1diz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Mart\u00ednez-Moya","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, University Hospital of Ja\u00e9n, 23007 Ja\u00e9n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jer\u00f3nimo","family":"Momblan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Torrec\u00e1rdenas Hospital, 04009 Almer\u00eda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso Mar\u00eda","family":"Lechuga-Sancho","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Puerta del Mar University Hospital, 11009 C\u00e1diz, Spain"},{"name":"Department of Maternal and Child Health and Radiology, School of Medicine, University of C\u00e1diz, 11003 C\u00e1diz, Spain"},{"name":"Biomedical Research and Innovation Institute of C\u00e1diz (INiBICA), Puerta del Mar University Hospital, 11009 C\u00e1diz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8215-2379","authenticated-orcid":false,"given":"Jos\u00e9 Mar\u00eda","family":"G\u00f3mez-Vida","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, San Cecilio Clinical University Hospital, 18016 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Mier-Palacios","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Juan Ram\u00f3n Jim\u00e9nez University Hospital, 21005 Huelva, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Pilar","family":"Ranchal-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Costa del Sol Hospital, 29603 Marbella, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Vivas-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Serran\u00eda de Ronda Hospital, 29400 Ronda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Calleja Cabeza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Alto Guadalquivir Hospital, 23740 And\u00fajar, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0951-8722","authenticated-orcid":false,"given":"Eugenio","family":"Fern\u00e1ndez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Instituto Hispalense de Pediatr\u00eda, 41013 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Pilar","family":"Jim\u00e9nez-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Infanta Margarita Hospital, 14940 Cabra, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Guarino-Narv\u00e1ez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Punta de Europa Hospital, 11207 Algeciras, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0951-5428","authenticated-orcid":false,"given":"Pablo","family":"Rodr\u00edguez de Vera-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen Macarena University Hospital, 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-122X","authenticated-orcid":false,"given":"Mar\u00eda Asunci\u00f3n","family":"Mart\u00ednez-Brocca","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen Macarena University Hospital, 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref_1","unstructured":"Kliegman, R.M., Geme, J.W.S., Blum, N.J., Shah, S.S., Tasker, R.C., and Wilson, K.M. 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