bluuebunny/crossref_metadata_2025_split huggingface dataset:
1292-P: Continuous Glucose Monitor Use Protects against the Negative Impact of Fear of Hypoglycemia on Sleep Parameters in Adolescents with Type 1 Diabetes
Authors: HITT TALIA A. , SMITH JENNIFER , FORTH EMILY L. , GARREN PATRIK , OLIVOS-STEWART DIANA , LA VEGA MONICA DE , STUART FIONA , HAWKES COLIN P. , WILLI STEVEN M. , GETTINGS JULIE 
Published: June 2020

Background: Adolescents with type 1 diabetes (T1D) are vulnerable to sleep difficulties that may negatively affect mental health and glycemic control. Fear of hypoglycemia (FOH) may contribute to these sleep problems. Although parental FOH has been associated with poor sleep quality in children with T1D, little is known about the relationship between adolescent FOH and sleep outcomes.
Objective: To examine the association between adolescent FOH and sleep parameters and assess how continuous glucose monitor (CGM) use influences these relationships.
Methods: Adolescents ages 14-18 years with T1D completed questionnaires evaluating FOH (Child Hypoglycemia Fear Survey) and sleep parameters (Pittsburgh Sleep Quality Index). Meaningful CGM use was defined as reporting using the device ≥ 50% of the time. Analyses included linear regression and T-tests.
Results: One hundred adolescents (56 female) with a median (IQR) age of 16.3 (15.3,17.6) years and duration of T1D of 5.7 (2.5, 9.5) years completed surveys, and 45 used CGM. FOH was inversely associated with sleep duration (r=0.25, p=0.01) and quality (r=0.22 p=0.03), and positively associated with sleep disturbances (r=0.24, p=0.01). A stratified analysis showed that the inverse relationship between FOH and sleep duration (r=0.29, p=0.03), as well as the association with sleep disturbances (r=0.31, p=0.02) was only significant among those not using CGM. Furthermore, average sleep duration was longer in those using CGM [7.5 hours with CGM vs. 6.8 hours without, p=0.02] and the associations between FOH and sleep duration or disturbance were not significant among CGM users.
Conclusions: Among adolescents with T1D, FOH is associated with reduced sleep duration, poor sleep quality and increased sleep disturbance. Our findings suggest that CGM use could mitigate the negative contribution of FOH on various sleep parameters in this population, a previously unrecognized benefit.

Disclosure
T.A. Hitt: None. J. Smith: None. E.L. Forth: None. P. Garren: None. D. Olivos-Stewart: None. M. De La Vega: None. F. Stuart: None. C.P. Hawkes: None. S.M. Willi: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Research Support; Self; Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Tolerion, Inc. Other Relationship; Self; Caladrius Biosciences, Inc. J. Gettings: None.
1293-P: Efficiency of Screening for Type 1 Diabetes and Celiac Disease in Various Health Care Settings: Autoimmunity Screening for Kids (ASK)
Authors: GENO RASMUSSEN CRISTY R. , WAUGH KATHLEEN , BAXTER JUDITH , STECK ANDREA , FROHNERT BRIGITTE I. , REWERS MARIAN 
Published: June 2020

Our goal was to explore feasibility of screening for pre-symptomatic type 1 diabetes (T1D) and celiac disease (CD) in the general population. Efficiency of and barriers to sustainable screening in various health care settings are described. From 2017-2019, the ASK study screened 23,578 children in Colorado. Of those, 0.94% were positive for islet (95% CI 0.82-1.08) and 2.10% for transglutaminase (95% CI 1.92-2.29) autoantibodies. The screening aimed to engage providers in hospital specialty clinics (HSC), emergency departments (ED), private primary care (PPC), government primary care (GPC), diabetes center (BDC), community events (CE), and retail clinics (RC). ASK provided, as needed, on-site screening staff, provider reimbursement, and electronic consenting. Efficiency was defined as #screened/research staff full-time effort per week. The majority (72%) of screenings were completed at an ED or HSC, with 91% of screenings conducted by ASK staff. Highest screening efficiency was in the ED (Figure 1). While efficient, RC yielded small numbers. Challenges to screening program implementation included inconsistent provider time and commitment, limited clinic space, competing priorities, and research constraints. Translation to a sustainable screening in primary care will need to address these challenges in a practice-specific fashion.

Disclosure
C.R. Geno Rasmussen: None. K. Waugh: None. J. Baxter: None. A. Steck: None. B.I. Frohnert: None. M. Rewers: None.

Funding
JDRF (3-SRA-2018-564-M-N)
1296-P: Omnipod Personalized MPC Algorithm at Target Glucose of 110mg/dl Is Safe in Children Aged 2-12 Years without Increasing Risk of Hypoglycemia
Authors: SHERR JENNIFER , BUCKINGHAM BRUCE A. , FORLENZA GREGORY P. , GALDERISI ALFONSO , EKHLASPOUR LAYA , WADWA R. PAUL , ZGORSKI MELINDA , KINGMAN RYAN S. , BERGET CARI , LEE JOON BOK , OCONNOR JASON B. , DUMAIS BONNIE , VIENNEAU TODD , HUYETT LAUREN M. , LY TRANG T. 
Published: June 2020

Customization of glucose targets in hybrid closed-loop (HCL) systems is important to enable tailored glucose management and safe onboarding across a wide range of users. The safety and performance of the Omnipod HCL personalized model predictive control (MPC) algorithm were assessed with a lower target of 110mg/dL for the first time in children aged 2-12y with type 1 diabetes (T1D) using an investigational device.
Participants with A1C&lt;10.0% completed a 72-96h HCL study conducted in a supervised free-living hotel setting. At HCL start, the glucose target was 120mg/dL, and was lowered to 110mg/dL after 24-48h. There were 1-2 missed lunch boluses, high fat meals, and daily exercise.
Participants (n=12) were (mean±SD): age 6.8±3.1y, T1D duration 3.7±2.9y, and A1C 7.1±0.7%. Despite 1-2 missed meal bolus challenges (mean 43g, range 18-88g CHO), percent time 70-180mg/dL was 76.6±7.2% and 80.4±9.9% with targets of 110mg/dL and 120mg/dL respectively. Outcomes were similar between the targets for mean glucose and time in glycemic ranges (Table). There were no serious adverse events.
The Omnipod personalized MPC algorithm performed well and was safe in children aged 2-12y with T1D when tested at a target of 110mg/dL, even when stress-tested under challenging conditions. This algorithm is being evaluated in an at-home pivotal study with targets 110-150mg/dL.

Disclosure
J. Sherr: Advisory Panel; Self; Bigfoot Biomedical, Cecelia Health. Consultant; Self; Eli Lilly and Company, Lexicon Pharmaceuticals, Inc., Medtronic, Sanofi, T1D Exchange. B.A. Buckingham: Advisory Panel; Self; ConvaTec Inc., Medtronic. Research Support; Self; Beta Bionics, Inc., Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. G.P. Forlenza: Advisory Panel; Self; Medtronic. Consultant; Self; Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care. Research Support; Self; Abbott, Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care. A. Galderisi: None. L. Ekhlaspour: None. R. Wadwa: Advisory Panel; Self; Eli Lilly and Company, Medtronic. Research Support; Self; Dexcom, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk Inc., Tandem Diabetes Care. M. Zgorski: None. R.S. Kingman: None. C. Berget: None. J. Lee: Employee; Self; Insulet Corporation. J.B. OConnor: None. B. Dumais: Employee; Self; Insulet Corporation. T. Vienneau: Employee; Self; Insulet Corporation. Stock/Shareholder; Self; Insulet Corporation. L.M. Huyett: Employee; Self; Insulet Corporation. T.T. Ly: Employee; Self; Insulet Corporation.

Funding
Insulet Corporation
1297-P: Early CGM Initiation Improves HbA1c in T1D Youth over the First 15 Months
Authors: PRAHALAD PRIYA , DING VICTORIA , ADDALA ANANTA , NEW CHRISTIN , CONRAD BARRY P. , CHMIELEWSKI ANNETTE , GEELS ELENA , LEVERENZ JEANNINE , MARTINEZ-SINGH ANJOLI , SAGAN PIPER , SENALDI JULIANNE , FREEMAN ALEX , SCHEINKER DAVID , HOOD KOREY K. , DESAI MANISHA , MAAHS DAVID M. 
Published: June 2020

CGM use is associated with lower HbA1c in people with T1D. We hypothesize early CGM initiation will improve longer term HbA1c.
Youth with newly diagnosed T1D from July 2018 to May 2019 (pilot cohort, n=65), were offered CGM initiation in the 1st month of T1D diagnosis with 62 initiating CGM. We compared HbA1c outcomes in this pilot cohort with those diagnosed in 2014-2016 (control cohort, n=272) with follow-up duration restricted to 15 months. HbA1c trajectories were visualized using locally estimated scatter plot smoothing (Figure 1) and compared using a generalized mixed effects regression model adjusted for baseline characteristics (HbA1c at onset, age, sex, race and insurance type).
Mean HbA1c at diagnosis was higher in the pilot cohort (12.0% vs. 10.7%). Over the first 15 months of T1D, CGM was initiated in 95% of the pilot cohort (78.5% within 30 days), whereas 56% initiated in the control cohort (1.8% within 30 days). Adjusting for baseline characteristics, mean HbA1c levels were 0.5% lower (95%CI: -1.0, -0.1) in the pilot cohort at 3 months and 1.7% lower (95% CI: -2.6, -0.8) at 6 months compared to the control cohort. Differences beyond 6 months were also in the expected direction and statistically significant at the 0.05 level.
Early initiation of CGM in the new onset period was associated with lower HbA1c compared to historic controls. These data suggest that early CGM initiation should be considered a part of standard new onset T1D care.

Disclosure
P. Prahalad: None. V. Ding: None. A. Addala: None. C. New: None. B.P. Conrad: None. A. Chmielewski: None. E. Geels: None. J. Leverenz: None. A. Martinez-Singh: None. P. Sagan: None. J. Senaldi: None. A. Freeman: None. D. Scheinker: None. K.K. Hood: Research Support; Self; Dexcom, Inc. Speaker’s Bureau; Self; LifeScan, Inc., MedIQ. M. Desai: None. D.M. Maahs: Advisory Panel; Self; Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S. Consultant; Self; Abbott, Sanofi. Research Support; Self; Bigfoot Biomedical, Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care.
1299-P: Ecological Momentary Assessment (EMA) of Positive and Negative Affect, Social Context, and Blood Glucose (BG) in Teens with Type 1 Diabetes
Authors: SHAPIRA AMIT , VOLKENING LISA K. , BORUS JOSHUA , LAFFEL LORI M. 
Published: June 2020

Aim: Affect and social context are associated with diabetes self-care in teens with T1D. We used EMA to examine associations of affect and social context with BG levels in teens with T1D.
Methods: Over 2 weeks, 32 teens reported positive (POS) and negative (NEG) affect (Positive and Negative Affect Schedule) and BG levels on handheld computers 4 times/day, coordinated with daily BG checks; at 3/4 times, teens also reported attitudes toward social context (i.e., strong desire to blend in, strong desire to impress others). Z-scores were calculated for NEG and POS subscales to reflect deviations from each teen’s overall affect. BG values were classified: 1) time in range (TIR) 70-180 mg/dL; 2) low &lt;70 mg/dL; 3) serious low &lt;54 mg/dL; 4) high &gt;180 mg/dL; 5) serious high &gt;250 mg/dL. Separate logistic generalized estimating equations, adjusted for age, sex, T1D duration, pump therapy, and A1c, determined associations between affect, social context, and BG ranges.
Results: Teens (44% male) were ages 14-18 years with T1D duration of 8.8±4.2 (M±SD) years; 63% were pump treated and A1c was 8.8±1.4%. Median 2-week EMA response rate was 72%. Average NEG and POS affect scores were 1.4±0.5 and 2.4±1.1, respectively. Teens reported a desire to impress others 8% of time and desire to blend in 9% of time. Teens reported 51% TIR, 6% low (2% serious low), and 44% high (19% serious high) BG. In adjusted models, more NEG affect was associated with lower odds of reporting a serious low BG (OR= 0.5, 95% CI: 0.3-0.9, p=.03) and higher odds of reporting a serious high BG (OR= 1.2, 95% CI: 1.1-1.4, p=.0002). NEG affect was not associated with TIR, low BG, or high BG. Neither POS affect nor social context were associated with any BG ranges.
Conclusions: In our sample, NEG affect was associated with BG &gt;250 mg/dL. Teens with T1D who experience NEG affect may not attend to diabetes self-care. Interventions targeting NEG affect may help improve diabetes self-care behaviors in teens with T1D.

Disclosure
A. Shapira: None. L.K. Volkening: None. J. Borus: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US.

Funding
JDRF International; National Institutes of Health (P30DK036836, K12DK094721)
13-LB: Leptin Treatment Prevents Impaired Hypoglycemic Counterregulation Induced by Exposure to Recurrent Hypoglycemia or Caloric Restriction
Authors: MCDOUGAL DAVID , DUVALL MARINA , SIKAFFY HUNTER X. , JARIWALA RAJVI , MORRISON CHRISTOPHER , HILL CRISTAL M. 
Published: June 2020

Background: Hypoglycemia-associated autonomic failure (HAAF) is a significant barrier to achieving optimal glucose levels in persons with diabetes. Our group and others have demonstrated that low leptin levels are concurrent with impaired hypoglycemic counter-regulation in two separate animal models of HAAF: six days of 60% caloric restriction (CR) in mice and 3 days of recurrent hypoglycemia (3dRH) in rats. In this study, we tested whether leptin treatment during CR or 3dRH could prevent the development of HAAF.
Methods: In experiment one, 3 groups of mice (two CR groups and one ad-lib fed control group) received either twice daily leptin (0.5-1μg/g, IP) or PBS. In experiment two, 3 groups of rats (two 3dRH and one control) received daily leptin or PBS injections (0.3-0 .7 mg/kg, IP). One day following the CR or 3dRH paradigms, all animals underwent a hypoglycemic ITT and levels of glucagon, leptin, epinephrine (rats), and corticosterone were assessed 60 min following insulin treatment.
Results: As expected, PBS treated CR mice and 3dRH rats had significantly reduced glucagon levels and epinephrine levels relative to controls (24 ± 5 vs. 95 ± 20 pmol/L and 57 ± 12 vs. 110 ± 9 ng/mL, respectively). In contrast, there was no differences in the glucagon levels of leptin treated CR mice and epinephrine levels of leptin treated 3dRH rats relative to their respective control groups. Leptin levels in both CR groups were reduced relative to controls (0.9 ± 0.3 and 0.2 ± 0.1 vs. 3.0 ± 0.5 ng/mL, respectively), while corticosterone was unchanged. Glucagon, corticosterone, and leptin levels were similar across groups in the 3dRH paradigm.
Discussion: Utilizing two separate animal models of HAAF, we established that leptin treatment can prevent the loss of hypoglycemic counter-regulation. Future studies investigating whether combining leptin treatment with insulin therapy could significantly reduce hypoglycemic complications in diabetes patients are warranted.

Disclosure
D. McDougal: None. M. DuVall: None. H.X. Sikaffy: None. R. Jariwala: None. C. Morrison: None. C.M. Hill: None.

Funding
American Diabetes Association (1-15-JF-37 to D.M.); National Institutes of Health (U54GM104940)
13-OR: Piloting the Problem Areas in Diabetes Scale in Clinical Practice: The DiaPROM Pilot Trial
Authors: HERNAR INGVILD , GRAUE MARIT , RICHARDS DAVID , STRANDBERG RAGNHILD B. , LØVAAS KARIANNE F. , MADSEN TONE VONHEIM , TELL GRETHE S. , HAUGSTVEDT ANNE 
Published: June 2020

Background: Diabetes distress is a potential barrier to self-management and satisfactory glycaemic control. A structured focus on diabetes distress using the Problem Areas in Diabetes (PAID) scale may improve the health of people with diabetes. We designed the DiaPROM trial, evaluating the effect of using electronically captured PAID in clinical practice, to reduce diabetes distress among adults with type 1 diabetes.
Methods: In this pilot trial, we aimed to evaluate PAID scores pre and post intervention and identify patients with elevated scores. We randomly assigned participants (18-≤40 yrs) at an outpatient clinic to standard care or an intervention were physicians referred individuals with a PAID score ≥30 or single item(s) ≥3 (moderately high distress) to minimum two nurse appointments. Following a communication manual based on empowerment and self-determination theory, reported problem areas were reviewed and discussed.
Results: We recruited 79 adults with type 1 diabetes (age 27.2 ±5.0 yrs, diabetes duration 13.7 ±7.0 yrs, HbA1c 65.4 ±14.5 mmol/mol). In the intervention group (n=39), baseline PAID score was 27.7 ±16.8; 23 (59%) participants qualified for additional follow up and 17 (44%) accepted referral, attending a mean of 2.2 ±1.1 appointments. At 12 month follow up, the intervention group (n=31) mean score was 21.7 ±14.4 (mean change 3.7 ±13.0), with 13 (42%) reporting moderately high distress. The control group (n=40) scored 24.1 ±14.3 at baseline and 26.2 ±14.5 at 12 months (n=36), with respectively 19 (48%) and 20 (56%) patients reporting moderately high distress. Between-group difference at 12 months was 5.5 (95% CI 0.25, 10.7).
Conclusion: Half of the participants reported diabetes distress levels qualifying for additional follow up, which has consequences for scaling a future RCT. Although the study was not powered to estimate intervention effects, we identified a promising PAID score reduction in the intervention group which was not observed for the controls.

Disclosure
I. Hernar: None. M. Graue: None. D. Richards: None. R.B. Strandberg: None. K.F. Løvaas: None. T. Madsen: None. G.S. Tell: None. A. Haugstvedt: None.
1311-P: Number of Daily Meals and Snacks Impacts Glycemic Outcomes in Youth with T1D
Authors: LA BANCA REBECCA O. , VOLKENING LISA K. , DASSAU EYAL , MEHTA SANJEEV N. , LAFFEL LORI M. 
Published: June 2020

Aim: Most youth with T1D meet neither nutrition guidelines nor glycemic goals. We assessed macronutrient content of meals/snacks and impact of daily number of meals/snacks on glycemic outcomes in youth with T1D over 1 year.
Methods: Youth completed 3-day food records (2 week days/1 weekend day) and wore 3-day masked CGM (iPro™) every 3 months for 1 year. Diet data were reviewed by 2 RDs and analyzed using Nutrition Data System for Research (NDSR). Glycemic outcomes were A1c and CGM metrics (glucose % time in range [TIR] 70-180 mg/dL, % time [T] &lt;70, %T&gt;180, and glucose CV [SD/mean]). Longitudinal mixed models assessed effect of number of daily meals/snacks on glycemic outcomes.
Results: Youth (N=136, ages 8-17, 48% male) were ages 12.8±2.5 years with T1D duration 5.9±3.1 years and daily insulin dose 0.9±0.3 U/kg; 73% used insulin pumps. Number of meals/snacks ranged from 1-9 with most youth (69%) reporting 3-4 meals/snacks daily. Macronutrient intake varied by meal/snack (Figure). An increase of 1 meal/snack per day led to a 0.1% decrease in A1c (p=.001), 2.4% (35 minutes/day) more TIR (p=.0006), and 3.1% (45 minutes/day) less T&gt;180 (p=.0001); T&lt;70 and CV were unchanged.
Conclusions: In youth with T1D, eating frequent meals/snacks may lead to lower A1c, more TIR, and less hyperglycemia. These findings may be due to dividing energy intake across the day with more frequent bolus dosing, given predominance of carbohydrates in meals/snacks.

Disclosure
R.O. La Banca: None. L.K. Volkening: None. E. Dassau: Consultant; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; Roche Diabetes Care. Other Relationship; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care. S.N. Mehta: None. L.M. Laffel: Advisory Panel; Self; Roche Diabetes Care. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Insulogic LLC, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc., Sanofi US.

Funding
National Institutes of Health (P30DK036836, K12DK094721)
1318-P: Characteristics of Autoimmune Thyroid Disease in African American and Caucasian Children with Type 1 Diabetes Mellitus
Authors: BEJJANI MIREILLE EL , ZIDAN MARWAN , ZIDAN HANAA 
Published: June 2020

Background: Patients with type 1 diabetes mellitus (T1DM) are at increased risk of autoimmune thyroid disease (AIT). In the pediatric age group, the prevalence of AIT varies across a wide range (3-50%), depending on the population studied. There is very limited data describing the association of T1DM and AIT disease in African-American (AA) children.
Objective: Characterize the association between T1DM and AIT in AA and Caucasian children presenting to the same medical center.
Methods: After IRB approval, the medical records of 130 AA and 130 Caucasian children with T1DM presenting to the Children’s Hospital of Michigan were reviewed. Data collected included age, gender, ethnicity, presence of AIT evidenced by positive anti-TPO or anti-TG antibodies, TSH, free T4, anti-islet, anti-insulin and anti-GAD antibodies. Comparison was drawn between the two ethnicities in regards to the prevalence of AIT as well as predisposing factors for the onset of AIT.
Results: 12.3% of AA with T1DM developed AIT versus 23.8% of Caucasian. This difference was statistically significant with a p-value of 0.023. In the Caucasian group, female was a risk factor for developing AIT (37.9% in females vs. 12.5% in males, p-value 0.001) while gender was not a significant risk factor for AA patients (p-value 0.790). The presence of anti-insulin antibodies was a risk factor for Caucasians (p-value 0.024) but not for AAs (p-value 0.185). The survival analysis showed mean time for onset of AIT in AA with T1DM is 15.1 years vs. 11.7 years in Caucasians (Log Rank p-value 0.025).
Discussion: Our study shows a significantly lower prevalence AIT in AA compared to Caucasian children with T1DM. Female gender and anti-insulin antibody are risk factors for Caucasians but not in AAs. Differences could be secondary to different genes implication given the different genetic background. Further investigation can lead to a better understanding of T1DM and thyroid autoimmunity in the AA population.

Disclosure
M. El Bejjani: None. M. Zidan: None. H. Zidan: Speaker’s Bureau; Self; Novo Nordisk Inc.
1321-P: Lower Use of Technology in Youth with Type 1 Diabetes in Locations Distant from Specialty Care
Authors: COBRY ERIN C. , REZNICK-LIPINA TYLER , PYLE LAURA , SLOVER ROBERT H. , THOMAS JOHN F. , ALONSO GUY T. , WADWA R. PAUL 
Published: June 2020

Pediatric patients with type 1 diabetes (T1D) who live far from a diabetes specialty clinic have fewer clinical visits. Telemedicine can increase visit frequency, but the impact on adoption of diabetes technology, such as insulin pumps and continuous glucose monitoring (CGM), is unclear.
Pediatric patients with T1D in Colorado and Wyoming who received diabetes care from our center via telemedicine were eligible to participate. As part of an ongoing telemedicine study, medical records were reviewed to ascertain technology use, and data were compared to patients whose care did not involve the use of telemedicine.
Patients (N=149, age 12.0 ± 4.3 yrs, T1D duration 2.7± 4.2 yrs, HbA1c 8.9 ± 1.8%, gender 60% male, race/ethnicity 74% non-Hispanic white, insurance status 68% private) who utilized telemedicine between 2012 and 2019 were included. Compared to the general clinic (N=2672), technology use was lower (pump: 64% vs. 77%, p = 0.001; CGM: 35% vs. 79%, p &lt;0.001; pump and CGM: 30% vs. 56%, p &lt;0.001). Use of technology among telemedicine patients was not associated with gender, T1D duration, insurance or distance from the main clinic but was associated with race/ethnicity and lower HbA1c (Table).
Diabetes technology use is lower in pediatric T1D patients using telemedicine. Additional research is needed to explore potential reasons for this discrepancy and methods to improve the use of diabetes technology in these patients.

Disclosure
E.C. Cobry: None. T. Reznick-Lipina: None. L. Pyle: None. R.H. Slover: None. J.F. Thomas: None. G.T. Alonso: None. R. Wadwa: Advisory Panel; Self; Eli Lilly and Company, Medtronic. Research Support; Self; Dexcom, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk Inc., Tandem Diabetes Care.

Funding
National Institutes of Health (K12DK094712); National Center for Research Resources (UL1TR002535)