Continuous glucose monitoring, automated insulin delivery, and remote care in adolescents with type 1 diabetes: advances toward integrated digital management
- 1General Office, China-Japan Union Hospital of Jilin University
- 2Department of Respiratory Medicine, China-Japan Union Hospital of Jilin University
Abstract
Type 1 diabetes management in adolescents remains challenging due to physiological and behavioral factors. This review summarizes recent advances in three interconnected technologies: continuous glucose monitoring (CGM), automated insulin delivery (AID), and remote care. CGM provides real-time glycemic data with time in range (TIR) as the core metric, improving glycemic outcomes when implemented with structured education. AID systems, particularly hybrid closed-loop devices, consistently increase TIR, reduce glycated hemoglobin (HbA1c), and lower risks of severe hypoglycemia and diabetic ketoacidosis (DKA) across randomized trials and real-world studies, with validated efficacy in children as young as 1-year-old. Remote care models leverage continuous data streams to enable individualized follow-up, showing glycemic outcomes approaching those of traditional visits in comparative studies while improving access and psychosocial support. Despite proven benefits, barriers remain, including socioeconomic inequities in technology access, alarm fatigue, and implementation gaps across healthcare systems. Future priorities include fully closed-loop systems, dual-hormone approaches, algorithm optimization for exercise and illness, long-term psychosocial outcomes, and equitable implementation strategies. Clinical practice should integrate these technologies through multidisciplinary teams, early initiation, and patient-centered support to transform adolescent diabetes care from intermittent visits to continuous digital management.
Related
- Glycaemic outcomes of three months of continuous glucose monitoring in children, adolescents and young adults with type 1 diabetes at a Kenyan tertiary hospital: a single-arm prospective study.
- An international position statement on practical approaches for inpatient continuous glucose monitoring, insulin pumps and automated insulin delivery systems in adults
- Cost‐effectiveness analysis comparing advanced hybrid closed‐loop automated insulin delivery with multiple daily insulin injections and continuous glucose monitoring in adults with type 1 diabetes in Japan
- Performance of a 15-Day Continuous Glucose Monitoring System in Children and Adolescents With Diabetes.
- Glycemic Dynamics and Management Strategies in Individuals With Type 1 Diabetes During Ramadan: A Continuous Glucose Monitoring-Based Narrative Review.
BibTeX
@article{jia2026continuous,
title = {{Continuous glucose monitoring, automated insulin delivery, and remote care in adolescents with type 1 diabetes: advances toward integrated digital management}},
author = {Ying Jia and Qidi Liu},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1991652},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1991652/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Continuous glucose monitoring, automated insulin delivery, and remote care in adolescents with type 1 diabetes: advances toward integrated digital management
AU - Ying Jia
AU - Qidi Liu
PY - 2026
DA - 2026/11/02
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1991652
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1991652/full
AB - Type 1 diabetes management in adolescents remains challenging due to physiological and behavioral factors. This review summarizes recent advances in three interconnected technologies: continuous glucose monitoring (CGM), automated insulin delivery (AID), and remote care. CGM provides real-time glycemic data with time in range (TIR) as the core metric, improving glycemic outcomes when implemented with structured education. AID systems, particularly hybrid closed-loop devices, consistently increase TIR, reduce glycated hemoglobin (HbA1c), and lower risks of severe hypoglycemia and diabetic ketoacidosis (DKA) across randomized trials and real-world studies, with validated efficacy in children as young as 1-year-old. Remote care models leverage continuous data streams to enable individualized follow-up, showing glycemic outcomes approaching those of traditional visits in comparative studies while improving access and psychosocial support. Despite proven benefits, barriers remain, including socioeconomic inequities in technology access, alarm fatigue, and implementation gaps across healthcare systems. Future priorities include fully closed-loop systems, dual-hormone approaches, algorithm optimization for exercise and illness, long-term psychosocial outcomes, and equitable implementation strategies. Clinical practice should integrate these technologies through multidisciplinary teams, early initiation, and patient-centered support to transform adolescent diabetes care from intermittent visits to continuous digital management.
SN - 1664-2392
ER -