Content of review 1, reviewed on December 14, 2024

The authors have reported the early benefits of AHCL use in youth with type 1 diabetes, highlighting the sustained improvement in glycemic control.

The association between baseline higher HbA1c levels, consistent use of the automatic mode, and a strong positive response to AID therapy is particularly noteworthy.

The study's findings emphasize the potential of innovative diabetes management technologies to achieve meaningful improvements, even in individuals with suboptimal baseline glucose control.

Below are some specific comments to improve the manuscript:

  • The authors should consider expanding the discussion regarding the observed relationship between a greater number of meal announcements and a more substantial increase in TIR.

While simplified carbohydrate counting has been validated as a practical approach, the importance of user education at the start of AID therapy remains paramount. Emphasizing the need for users to engage with the system by announcing meals appropriately could enhance the device's performance and outcomes.

  • Literature indicates that AHCL therapy not only improves glycemic outcomes but also contributes to psychological well-being (doi: 10.1111/dme.15449). Including this aspect in the discussion would provide a more comprehensive view of the therapy's benefits, addressing both clinical and psychosocial dimensions.

  • Recent real-world studies have demonstrated the benefits of AID systems for youth with persistently high HbA1c levels (doi: 10.1089/dia.2024.0148; doi: 10.2337/dc23-2311). Integrating these references into the discussion would enhance its visibility within the broader context of emerging evidence.

  • The term "automation" should be replaced with "automatic mode" throughout the manuscript.

  • A thorough revision of the manuscript’s language and style is recommended to enhance its scientific clarity and appeal.

Source

    © 2024 the Reviewer.

Content of review 2, reviewed on January 05, 2025

I appreciated the authors' effort to address all the issues. The manuscript, in its current version, is further improved.

Source

    © 2025 the Reviewer.

References

    Yongwen, Z., Alisa, B., R., M. V., K., G. M., Craig, J., Esko, W., G., P. R., Amber, P., Maheen, P., Goran, P., I., d. B. M., J., W. B. 2025. Predictors of glycaemic improvement in children and young adults with type 1 diabetes and very elevated HbA1c using the MiniMed 780G system. Diabetes, Obesity and Metabolism.