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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02975-y

摘要内容如下：

很少有年轻的1型糖尿病（T1D）患者达到血糖目标。连续血糖监测可改善血糖，但不公平。我们前瞻性地评估了实施更严格的血糖目标（HbA1c<7%）、早期技术使用（诊断后<1个月开始连续血糖监测）和远程患者监测的系统和公平的基于数字健康团队的护理计划对参加团队合作、目标、技术和严格控制（4T研究1）的新诊断T1D年轻人的血糖的影响。主要转归是诊断后4至12个月的HbA1c变化；次要结果是达到HbA1c目标。4T研究1队列（36.8%的西班牙裔和35.3%的公共保险）的平均HbA1c为6.58%，64%的HbA1c<7%，诊断后1年的平均时间范围（70-180mgdl-1）为68%。4T研究1的临床实施达到了预先指定的主要结果，血糖改善，无意外严重不良事件。4T研究1中的策略可用于对患有T1D的个体实施系统和公平的护理，并转化为对其他慢性疾病的护理。ClinicalTrials.gov注册：NCT04336969。

英文原文如下：

Abstracts

Few young people with type 1 diabetes (T1D) meet glucose targets. Continuous glucose monitoring improves glycemia, but access is not equitable. We prospectively assessed the impact of a systematic and equitable digital-health-team-based care program implementing tighter glucose targets (HbA1c < 7%), early technology use (continuous glucose monitoring starts <1 month after diagnosis) and remote patient monitoring on glycemia in young people with newly diagnosed T1D enrolled in the Teamwork, Targets, Technology, and Tight Control (4T Study 1). Primary outcome was HbA1c change from 4 to 12 months after diagnosis; the secondary outcome was achieving the HbA1c targets. The 4T Study 1 cohort (36.8% Hispanic and 35.3% publicly insured) had a mean HbA1c of 6.58%, 64% with HbA1c < 7% and mean time in the range (70-180 mg dl-1) of 68% at 1 year after diagnosis. Clinical implementation of the 4T Study 1 met the prespecified primary outcome and improved glycemia without unexpected serious adverse events. The strategies in the 4T Study 1 can be used to implement systematic and equitable care for individuals with T1D and translate to care for other chronic diseases. ClinicalTrials.gov registration: NCT04336969 .

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