ArticleThe Journal of clinical endocrinology and metabolism2022
Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Type 1 Diabetes: the Pilot 4T Study.
Article in The Journal of clinical endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- Real-World Evidence of Automated Insulin Delivery System Use.Diabetes technology & therapeutics · 2024Pooled it
- Effect of an Intensive, Integrated Telehealth Intervention on Glycemic Control in Children and Adolescents With Type 1 Diabetes Using Continuous Glucose Monitoring: A Randomized, Crossover Trial.Pediatric diabetes · 2025Trial
- Pilot Study of Early Adoption of Automated Insulin Delivery in Underresourced Youth.Journal of diabetes research · 2025Trial
- Smart Start - Designing Powerful Clinical Trials Using Pilot Study Data.NEJM evidence · 2024Trial
- Remote glucose monitoring is feasible for patients and providers using a commercially available population health platform.Frontiers in endocrinology · 2023Trial
- Determinants, implementation strategies, and mechanisms of the 4T Program.Journal of clinical & translational endocrinology · 2026Article
- Article
- A Quantitative Framework for Evaluating the Performance of Algorithm-Directed Whole-Population Remote Patient Monitoring: Tutorial for Type 1 Diabetes Care.JMIR diabetes · 2026Article
- Social Determinants of Health Impact on Pediatric Type 1 Diabetes Outcomes Early after Diagnosis.Hormone research in paediatrics · 2026Article
- Improving Diabetes Care Through Teamwork, Comprehensive Education, Tighter Goals, and Technology: Single-Center Data from TürkiyeJournal of clinical research in pediatric endocrinology · 2026Article
- Insights and Advances in Physical Activity Research on Youth with Type 1 Diabetes.Current diabetes reports · 2026Review
- Sustained HbA1c Improvements Over 36 Months in Youth in the Teamwork, Targets, Technology, and Tight Control (4T) Study.The Journal of clinical endocrinology and metabolism · 2026Article
- 14. Children and Adolescents: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- 7. Diabetes Technology: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Insulin dose adjustment policy for certified diabetes care and education specialists: Safe and effective.Journal of clinical & translational endocrinology · 2025Article
- Regression discontinuity in Time: Evaluating the impact of evolving digital health interventions.International journal of medical informatics · 2025Article
- Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial.PLOS digital health · 2025Article
- Disparities in Time to Technology Initiation in the Year Following Diagnosis of Type 1 Diabetes among Youth: A Retrospective Cohort Study.Journal of diabetes science and technology · 2025Article
- Psychosocial outcomes in a diverse sample of youth and their families who initiated continuous glucose monitoring within the first year of type 1 diabetes diagnosis.Diabetes, obesity & metabolism · 2025Article
- 7. Diabetes Technology: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
contextYouth with type 1 diabetes (T1D) do not meet glycated hemoglobin A1c (HbA1c) targets.
objectiveThis work aimed to assess HbA1c outcomes in children with new-onset T1D enrolled in the Teamwork, Targets, Technology and Tight Control (4T) Study.
methodsHbA1c levels were compared between the 4T and historical cohorts. HbA1c differences between cohorts were estimated using locally estimated scatter plot smoothing (LOESS). The change from nadir HbA1c (month 4) to 12 months post diagnosis was estimated by cohort using a piecewise mixed-effects regression model accounting for age at diagnosis, sex, ethnicity, and insurance type. We recruited 135 youth with newly diagnosed T1D at Stanford Children's Health. Starting July 2018, all youth within the first month of T1D diagnosis were offered continuous glucose monitoring (CGM) initiation and remote CGM data review was added in March 2019. The main outcomes measure was HbA1c.
resultsHbA1c at 6, 9, and 12 months post diagnosis was lower in the 4T cohort than in the historic cohort (-0.54% to -0.52%, and -0.58%, respectively). Within the 4T cohort, HbA1c at 6, 9, and 12 months post diagnosis was lower in those patients with remote monitoring than those without (-0.14%, -0.18% to -0.14%, respectively). Multivariable regression analysis showed that the 4T cohort experienced a significantly lower increase in HbA1c between months 4 and 12 (P < .001).
conclusionA technology-enabled, team-based approach to intensified new-onset education involving target setting, CGM initiation, and remote data review statistically significantly decreased HbA1c in youth with T1D 12 months post diagnosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.