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Article History

Received: 30 April 2026

Accepted: 30 June 2026

First Online: 7 September 2026

Ethics

Acknowledgements: The authors are grateful to the participating families and children and all members of the Fr1da study team. We also thank all primary care paediatricians and clinical centres participating in the Fr1da study group, as well as E. Bonnin (Institute for Diabetes Research, Helmholtz Munich) for supporting the manuscript submission.

Data availability: All datasets generated and analysed during the current study are not publicly available but are available from the corresponding author on reasonable request. Requests should include a project description outlining the proposed use of the data and the scientific rationale. Data access is subject to completion of a data use agreement with Helmholtz Munich.

Funding: Open Access funding enabled and organized by Projekt DEAL. This study was supported by a grant from the EASD-Novo Nordisk Foundation Diabetes Prize for Excellence (NNF22SA0081044) and the German Center for Diabetes Research (DZD e.V.). Both sensor systems, namely the FreeStyle Libre Pro iQ and previously the Dexcom G6, were purchased using institutional funds from Helmholtz Munich. The Fr1da study was supported by Breakthrough T1D (formerly Juvenile Diabetes Research Foundation International: 1-SRA-2014-310-M-R, 3-SRA-2019-718-Q-R, 3-SRA-2015–72-M-R, 3-SRA-2026-1795-S-B), LifeScience Stiftung (HMGU 2014.01 and HMGU 2016.01), the Leona M. and Harry B. Helmsley Charitable Trust (G-1911-3274, 2017PG-T1D023, 2016PG-T1D020), the Deutsche Diabetiker Bund e.V. and the Bavarian Ministry of Economic Affairs, Energy, and Technology (Digital Lab). The funding sources were not involved in the design or conduct of the study or the decision to submit the manuscript for publication.

Authors’ relationships and activities: A-GZ served as a member of advisory boards for Sanofi-Aventis and Novo Nordisk and received support to give lectures sponsored by Sanofi-Aventis. EB received support for travel and accommodation to attend international conferences and to give lectures sponsored by Sanofi-Aventis. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.

Contribution statement: A-GZ was the principal investigator and designed the study. AW and EB performed the statistical analysis. A-GZ, EB, AW and EH drafted the manuscript. All authors acquired data, contributed to the interpretation of data and critically reviewed the manuscript. All authors reviewed and approved the manuscript for publication. A-GZ is the guarantor of this work and, as such, has full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.