Few young people with type 1 diabetes (T1D) meet glucose targets. Continuous glucose monitoring improves glycemia, but access is not equitable. We prospectively assessed the impact of a systematic and equitable digital-health-team-based care program implementing tighter glucose targets (HbA1c < 7%), early technology use (continuous glucose monitoring starts <1 month after diagnosis) and remote patient monitoring on glycemia in young people with newly diagnosed T1D enrolled in the Teamwork, Targets, Technology, and Tight Control (4T Study 1). Primary outcome was HbA1c change from 4 to 12 months after diagnosis; the secondary outcome was achieving the HbA1c targets. The 4T Study 1 cohort (36.8% Hispanic and 35.3% publicly insured) had a mean HbA1c of 6.58%, 64% with HbA1c < 7% and mean time in the range (70–180 mg dl⁻¹) of 68% at 1 year after diagnosis. Clinical implementation of the 4T Study 1 met the prespecified primary outcome and improved glycemia without unexpected serious adverse events. The strategies in the 4T Study 1 can be used to implement systematic and equitable care for individuals with T1D and translate to care for other chronic diseases. ClinicalTrials.gov registration: NCT04336969.

患有 1 型糖尿病 (T1D) 的年轻人很少能达到血糖目标。持续血糖监测可改善血糖，但获取机会并不公平。我们前瞻性地评估了基于数字健康团队的系统且公平的护理计划的影响，该计划实施更严格的血糖目标（HbA1c < 7%）、早期技术使用（诊断后 1 个月内开始连续血糖监测）以及远程患者血糖监测新诊断 T1D 的年轻人参加了团队合作、目标、技术和严格控制（4T 研究 1）。主要结局是诊断后 4 至 12 个月的 HbA1c 变化；次要结果是实现 HbA1c 目标。 4T 研究 1 队列（36.8% 西班牙裔和 35.3% 公共保险）的平均 HbA1c 为 6.58%，64% 的 HbA1c < 7%，平均时间范围 (70–180 mg dl ⁻¹ ) 在 1 时为 68%。诊断后一年。 4T 研究 1 的临床实施达到了预先设定的主要结果并改善了血糖，没有出现意外的严重不良事件。 4T 研究 1 中的策略可用于为 T1D 患者实施系统且公平的护理，并转化为对其他慢性疾病的护理。 ClinicalTrials.gov 注册：NCT04336969。