Treatment regimens and glycaemic outcomes in more than 100 000 children with type 1 diabetes (2013-22): a longitudinal analysis of data from paediatric diabetes registries.

Background: Advances in paediatric type 1 diabetes management and increased use of diabetes technology have led to improvements in glycaemia, reduced risk of severe hypoglycaemia, and improved quality of life. Since 1993, progressively lower HbA targets have been set. The aim of this study was to perform a longitudinal analysis of HbA, treatment regimens, and acute complications between 2013 and 2022 using data from eight national and one international paediatric diabetes registries.

Depression Rates in Youth With Type 1 Diabetes During the COVID-19 Pandemic: Data From the T1D Exchange Quality Improvement Collaborative.

This study used data from the T1D Exchange Quality Improvement Collaborative to compare depression rates in youth with type 1 diabetes before and during the coronavirus disease 2019 (COVID-19) pandemic and identify characteristics of individuals with moderate-to-severe depressive symptoms. Rates of moderate-to-severe depressive symptoms remained stable before and during the pandemic, at 9.6-10.

Variability in Body Mass Index during 2018-2021 for People with Type 1 Diabetes: Real World Data from the USA, Germany, and Australasia.

Introduction: The COVID-19 pandemic necessitated worldwide lockdowns in 2020 and 2021, with restrictions on physical activity and changes in eating habits. The aim of this study was to investigate temporal trends in body mass index (BMI) and BMI Standard Deviation Score (SDS) in three international type 1 diabetes (T1D) registries between 2018 and 2021.

Methods: Data were extracted from DPV (Germany/Austria/Luxembourg/Switzerland), T1D Exchange Quality Improvement Collaborative (T1DX-QI, USA), and the Australasian Diabetes Data Network (ADDN, Australia/New Zealand).

Demographic, Clinical, Management, and Outcome Characteristics of 8,004 Young Children With Type 1 Diabetes.

Objective: To compare demographic, clinical, and therapeutic characteristics of children with type 1 diabetes age <6 years across three international registries: Diabetes Prospective Follow-Up Registry (DPV; Europe), T1D Exchange Quality Improvement Network (T1DX-QI; U.S.), and Australasian Diabetes Data Network (ADDN; Australasia).

Insulin Pump Utilization in 2017-2021 for More Than 22,000 Children and Adults With Type 1 Diabetes: A Multicenter Observational Study.

This large type 1 diabetes cohort study showed that insulin pump utilization has increased over time and that use differs by sex, insurance type, and race/ethnicity. Insulin pump use was associated with more optimal A1C, increased use of continuous glucose monitoring (CGM), and lower rates of diabetic ketoacidosis and severe hypoglycemia. People who used an insulin pump with CGM had lower rates of acute events than their counterparts who used an insulin pump without CGM.

Association Between Health Insurance Type and Adverse Outcomes for Children and Young Adults With Type 1 Diabetes and Coronavirus Disease 2019.

Background: Health insurance coverage type differs significantly by socioeconomic status and racial group in the United States. The aim of this study was to determine whether publicly insured children and young adults with type 1 diabetes were more likely to experience adverse outcomes compared with privately insured patients with acute coronavirus disease 2019 (COVID-19) infections.

Methods: Data from 619 patients with previously established type 1 diabetes who were <24 years of age with acute COVID-19 infections were analyzed from the T1D Exchange COVID-19 surveillance registry.

Longitudinal Trends in Glycemic Outcomes and Technology Use for Over 48,000 People with Type 1 Diabetes (2016-2022) from the T1D Exchange Quality Improvement Collaborative.

Previous studies revealed that hemoglobin A1c (HbA1c) increased overall in the United States in the past decade. In addition, health inequities in type 1 diabetes (T1D) outcomes by race/ethnicity and insurance type persist. This study examines the trends in HbA1c from 2016 to 2022 stratified by race/ethnicity and insurance in a large multicenter national database.

Factors Associated With Achieving Target A1C in Children and Adolescents With Type 1 Diabetes: Findings From the T1D Exchange Quality Improvement Collaborative.

The optimal care of type 1 diabetes involves consistent glycemic management to avoid short- and long-term complications. However, despite advancements in diabetes technology and standards, achieving adequate glycemic levels in children and adolescents remains a challenge. This study aimed to identify factors associated with achieving the recommended A1C target of <7% from the United States-based multicenter T1D Exchange Quality Improvement Collaborative cohort, including 25,383 children and adolescents living with type 1 diabetes.

Factors Associated With Improved A1C Among Adults With Type 1 Diabetes in the United States.

Many adults with diabetes do not reach optimal glycemic targets, and, despite advances in diabetes management, diabetes technology use remains significantly lower in racial/ethnic minority groups. This study aimed to identify factors associated with achieving the recommended A1C target of <7% using data on 12,035 adults with type 1 diabetes from 15 centers participating in the T1D Exchange Quality Improvement Collaborative. Individuals attaining the target A1C were more likely to be older, White, have private health insurance, and use diabetes technology and less likely to report depressive symptoms or episodes of severe hypoglycemia or diabetic ketoacidosis than those with higher A1C levels.

Implementation of Psychosocial Screening into Diabetes Clinics: Experience from the Type 1 Diabetes Exchange Quality Improvement Network.

Purpose Of Review: Although advances in diabetes technology and pharmacology have significantly and positively impacted diabetes management and health outcomes for some, diabetes care remains burdensome and can be challenging to balance with other life priorities. The purpose of this article is to review the rationale for assessment of psychosocial domains in diabetes care settings and strategies for the implementation of psychosocial screening into routine practice. Survey data from the Type 1 Diabetes Exchange Quality Improvement Network is highlighted.

Comorbidities increase COVID-19 hospitalization in young people with type 1 diabetes.

Objectives: We evaluated COVID-19 outcomes in children and young adults with type 1 diabetes (T1D) to determine if those with comorbidities are more likely to experience severe COVID-19 compared to those without.

Research Design And Methods: This cross-sectional study included questionnaire data on patients <25 years of age with established T1D and laboratory-confirmed COVID-19 from 52 sites across the US between April 2020 and October 2021. We examined patient factors and COVID-19 outcomes between those with and without comorbidities.

Implicit Racial-Ethnic and Insurance-Mediated Bias to Recommending Diabetes Technology: Insights from T1D Exchange Multicenter Pediatric and Adult Diabetes Provider Cohort.

Despite documented benefits of diabetes technology in managing type 1 diabetes, inequities persist in the use of these devices. Provider bias may be a driver of inequities, but the evidence is limited. Therefore, we aimed to examine the role of race/ethnicity and insurance-mediated provider implicit bias in recommending diabetes technology.

Trends in Type 1 Diabetic Ketoacidosis During COVID-19 Surges at 7 US Centers: Highest Burden on non-Hispanic Black Patients.

Context: The impact of the COVID-19 pandemic on individuals with type 1 diabetes remains poorly defined.

Objective: We examined United States trends in diabetic ketoacidosis (DKA) among individuals with type 1 diabetes (T1D) during the COVID-19 pandemic at 7 large US medical centers and factors associated with these trends.

Methods: We compared DKA events among children and adults with T1D during COVID-19 surge 1 (March-May 2020) and COVID-19 surge 2 (August-October 2020) to the same periods in 2019.

Age and Hospitalization Risk in People With Type 1 Diabetes and COVID-19: Data From the T1D Exchange Surveillance Study.

Context: COVID-19 morbidity and mortality are increased in type 1 diabetes (T1D), but few data focus on age-based outcomes.

Objective: This work aimed to quantify the risk for COVID-19-related hospitalization and adverse outcomes by age in people with T1D.

Methods: For this observational, multisite, cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 56 clinical sites in the United States, data were collected from April 2020 to March 2021.

Diabetic ketoacidosis drives COVID-19 related hospitalizations in children with type 1 diabetes.

Background: Diabetes is a risk factor for poor COVID-19 outcomes, but pediatric patients with type 1 diabetes are poorly represented in current studies.

Methods: T1D Exchange coordinated a US type 1 diabetes COVID-19 registry. Forty-six diabetes centers submitted pediatric cases for patients with laboratory confirmed COVID-19.