Evidence map›Paper›PMID 40635651›Full record

ArticleThe Journal of clinical endocrinology and metabolism2026

Sustained HbA1c Improvements Over 36 Months in Youth in the Teamwork, Targets, Technology, and Tight Control (4T) Study.

Priya Prahalad, Victoria Y Ding, Dessi P Zaharieva, Ananta Addala, Ramesh Johari, David Scheinker, Korey K Hood, Manisha Desai, David M Maahs

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In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Priya PrahaladDepartment of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0002-3894-4344
Victoria Y DingDepartment of Medicine, Quantitative Sciences Unit, Stanford University, Stanford, CA 94305, USA.
Dessi P ZaharievaDepartment of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0002-9374-8469
Ananta AddalaDepartment of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0002-0508-4309
Ramesh JohariStanford Diabetes Research Center, Stanford University, Stanford, CA 94305, USA.
David ScheinkerDepartment of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0001-5885-8024
Korey K HoodDepartment of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0001-5730-7749
Manisha DesaiDepartment of Medicine, Quantitative Sciences Unit, Stanford University, Stanford, CA 94305, USA.
David M MaahsDepartment of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA 94304, USA.

Funding

Stanford Center for Clinical and Translational Research and EducationUM1TR004921 · STANFORD UNIVERSITY · 2025 to 2025
$10.0M
Tissue ProcurementP30CA124435 · STANFORD UNIVERSITY · 2025 to 2025
$4.7M
Stanford Islet Research CoreP30DK116074 · STANFORD UNIVERSITY · 2025 to 2025
$2.0M
Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Pediatric T1D: 4T StudyR18DK122422 · NIDDK · STANFORD UNIVERSITY · PI David Matthew Maahs · 2022 to 2022
$678k
Reducing Disparities in Pediatric Diabetes: Building the Evidence Base to Inform Effective Diabetes Technology Interventions in Underrepresented MinoritiesK23DK131342 · STANFORD UNIVERSITY · 2025 to 2025
$194k
Helmsley Charitable Trust G-2002-04251-2Lucile Packard Children's Hospital Auxiliaries EndowmentNational Science Foundation 2205084NCATS NIH HHS UM1 TR004921NCI NIH HHS P30 CA124435NIDDK NIH HHS K23 DK131342NIDDK NIH HHS P30 DK116074NIDDK NIH HHS R18 DK122422NIHNIH HHS UM1TR004921Stanford Cancer Institute P30CA124435Stanford Diabetes Research Center 1P30DK11607401Stanford Diabetes Research Center R18DK122422Stanford Human-Centered Artificial IntelligenceStanford Maternal & Child Health Research InstituteStanford REDCap Platform UL1 T001085
6 · The paper itself

Abstract

contextYouth with type 1 diabetes (T1D) struggle to meet and sustain hemoglobin A1c (HbA1c) targets. Youth enrolled in the Pilot 4T Study improved HbA1c by 0.5% at 1 year, compared to historical controls.

objectiveTo assess 3 years of glycemic outcomes in the Pilot 4T Study.

methodsThe Pilot 4T Extension cohort was prospectively followed to determine changes in HbA1c and continuous glucose monitoring (CGM) metrics over 3 years at the Stanford Medicine Children's Health Diabetes Clinic. Youth with T1D in the Pilot 4T Study enrolled in the extension phase started CGM in the first month of diabetes diagnosis, received intensified education and remote patient monitoring (RPM) weekly for the first year of diabetes diagnosis, and monthly RPM in the extension phase. HbA1c and CGM metrics were evaluated over the first 3 years of diagnosis.

resultsIn the Pilot 4T cohort, 78.5% (n = 102) of participants enrolled in the study extension phase and were followed through 3 years. The adjusted difference in HbA1c at 3 years was 1.2% (95% CI 0.7%-1.7%) lower in the Pilot 4T cohort than in the Historical cohort. In the Pilot 4T cohort, 68% and 37% met the <7.5% and <7% HbA1c targets at 3 years, respectively, compared to 37% and 20% in the Historical cohort.

conclusionYouth with T1D in the Pilot 4T extension phase sustained improvements in HbA1c over 3 years. Focusing resources on intensive management during the first year after T1D diagnosis may impact long-term glycemia.

Indexed as

Diabetes Mellitus, Type 1Glycated HemoglobinGlycemic ControlAdolescentBlood GlucoseBlood Glucose Self-MonitoringChildFemaleFollow-Up StudiesHumansHypoglycemic AgentsMalePilot ProjectsProspective StudiesBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agentsdiabetes technologyhealth care deliverypediatric diabetestype 1 diabetes

Identifiers

PMID40635651
PMCPMC12752886

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.