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Article History

Received: 19 November 2025

Accepted: 19 December 2025

First Online: 1 February 2026

Declarations

:

: TM has received research grants or contracts from the following entities: Terumo Corporation, Medtronic Japan Co. Ltd., Raxi.and Consulting fees Roche, and has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the following entities: Dexcom Inc., Medtronic Japan Co. Ltd., Novo Nordisk Pharma Ltd., ARKRAY, Inc., Sanofi, Abbott. YH has received research grants or contracts from the following entities: Sumitomo Pharma Co. Ltd., Kyowa Kirin Co. Ltd., Medtronic Japan Co. Ltd., and Nippon Boehringer Ingelheim Co. Ltd., and has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the following entities: Eli Lilly Japan K.K., Sanofi, Terumo Corp., Sumitomo Pharma Co. Ltd., Novo Nordisk Pharma Ltd., Abbott Japan LLC., Medtronic Japan Co. Ltd., Dexcom Inc., Mitsubishi Tanabe Pharma Co., Daiichi Sankyo Co., Teijin Pharma Ltd., Sanwa Kagaku Kenkyusho Co., Novartis Pharma K.K., Kyowa Kirin Co. Ltd., Roche Diagnostics K.K., Kowa Co. Ltd., Otsuka Pharmaceutical Co. Ltd., Nippon Boehringer Ingelheim Co. Ltd., LifeScan Japan K.K., Nipro Corp., and Mochida Pharmaceutical Co., Ltd. JM has received costs for commissioned research from Terumo Corporation and Sanofi, and has received honoraria for lectures from Life Scan Co, Ltd, Abott Japan, Terumo, Novo Nordisk, Kowa Co. +td, Arkray Marketing Co., Ltd.,Sanofi Co., Ltd., Eli Lilly Japan K.K., Medtronic Japan, Ltd., Nipro Corporation, Sumitomo Pharma Co., Ltd. Astellas Pharma Inc. Dexcom Japan Co., Ltd.,and JM has the following leadership or fiduciary roles (paid or unpaid): Japanese Diabetes Society, Academic Council Member – Unpaid. Japanese Society for Advanced Diabetes and Type 1 Diabetes, Research Committee Member – Unpaid. Pediatric Insulin Therapy Research Committee Member – Unpaid. Japanese Society for Pediatric and Adolescent Diabetes, Vice President and Board Member – Unpaid. Tokyo Women’s Medical University, Academic Council Member – Unpaid. Research Committee on Exploratory Studies of New Pathophysiological Mechanisms in Type 1 Diabetes, Japanese Diabetes Society – Paid per meeting. Research Committee on the Development of Appropriate Treatment Based on an Analysis of the Current Status of Type 1 Diabetes in Japan, Japanese Diabetes Society – Paid per meeting. MT has received costs for commissioned research from Dexcom Inc., LifeScan Japan K.K. and has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the following entities: Eli Lilly Japan K.K, Mitsubishi Tanabe Pharma Co, Kowa Co. Ltd., Terumo Corp, Sumitomo Pharma Co. Ltd., Novo Nordisk Pharma Ltd., Nippon Boehringer Ingelheim Co. Ltd., Daiichi Sankyo Co. Ltd., Kissei Pharmaceutical Co., Ltd., Sanwa Kagaku Kenkyusho Co Ltd., AstraZeneca K.K., Dexcom Inc., Abbott Japan LLC. AT has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the following entities: LifeScan Japan K.K.Medtronic Japan Co.,Ltd. Eli Lilly Japan K.K.Sanofi K.K., Kowa Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Pharma Ltd.Sanwa Kagaku Kenkyusho Co., Ltd., Sumitomo Pharma Co., Ltd. Novartis Pharma K.K., Taisho Pharmaceutical Co., Ltd.Kyowa Kirin Co.,Ltd., Abbott Japan LLC, Nippon Boehringer Ingelheim Co., Ltd., Terumo Corporation, SyncHealth Inc., Roche Diagnostics K.K., Arkray Marketing, Inc., Dexcom, Inc. Other members declare no competing interests.

: This study conformed to the standards of the Declaration of Helsinki. Approval of the research protocol: The present study was approved by the ethics committee of the National Hospital Organization Kyoto Medical Center (No.19–072, Approval Date.20/Jan/ 2020). Written informed consent or substitute for it was obtained from all patients for being included in the study. Approval date of Registry and the Registration No. of the study/trial: Trial registration number: University hospital Medical Information Network (UMIN) Center: UMIN000039376).

: N/A.