The paper by Reznik and co-authors delas with a really important topic (mental health of patients with type 1 diabetes).

Authors conclude that adult patients with type 1 diabetes show an improvement in diabetes burden after 6 months of use of a HCL system, while no difference has been oibserved in the adolescent group.

Of note that adoelscents show lower stress and diabetes burden than adults at baseline.

Thank you for the opportunity to review the paper.

In my humble opinion the major limitation is the lack of a real control group with patients who do not use a HCL system.

I am also wondering if Authors can speculate why adult patients had such high level of diabetes burden?

Do they have complications? Is this related to HbA1c levels? Anything else?