Despite lower haemoglobin A1c with second‐generation automated insulin delivery systems, mental burden remains high for all adults with type 1 diabetes: A BETTER registry analysis
Authors' conclusion
In real-world settings, second-generation AIDs were associated with lower haemoglobin A1c and higher treatment satisfaction but not better PROs/PREs. Mental burden remained high despite the use of advanced diabetes technologies and optimal glucose management.
Study context
- Population
- Adults with T1D, Canadian BETTER registry; 69.2% females, mean age 45.3 ± 15.3 years, diabetes duration 24.7 ± 16.0 years
- Participants
- 1,731 adults
- Exposure
- Second-generation AID vs other treatment modalities
- Outcome
- Achieving target HbA1c ≤ 7%
Methodological detailsregistry analysis, adjusted generalized linear models
- Registry analysis
- Adjusted generalized linear models
Main finding
As reported in the abstract
HbA1c ≤ 7%
P < 0.001
Observational data: associations, not effects.
Further findings
PROs/PREs
- Higher treatment satisfaction with second-generation AID; no other PRO/PRE differences vs other groups
Elevated diabetes distress and poor sleep quality across all groups
- Elevated diabetes distress
- 55%
- Poor sleep quality
- 63%
- Elevated diabetes distress among those at optimal HbA1c target
- 48%
- Poor sleep quality among those at optimal HbA1c target
- 60%
Original publication
Despite lower haemoglobin A1c with second‐generation automated insulin delivery systems, mental burden remains high for all adults with type 1 diabetes: A BETTER registry analysis. Diabetes Obes Metab. Published 18 November 2025. doi:10.
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