In both pediatric and adult populations with type 1 diabetes (T1D), technologies such as continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), or sensor-augmented pumps (SAP) can consistently improve glycemic control [measured as glycated hemoglobin (HbA1c) and time in range (TIR)] while reducing the risk of hypoglycemia. Use of technologies can thereby improve quality of life and reduce the burden of diabetes management compared with self-injection of multiple daily insulin doses (MDI). Novel hybrid closed-loop (HCL) systems represent the latest treatment modality for T1D, combining modern glucose sensors and insulin pumps with a linked control algorithm to offer automated insulin delivery in response to blood glucose levels and trends. HCL systems have been associated with increased TIR, improved HbA1c, and fewer hypoglycemic events compared with CSII, SAP, and MDI, thereby potentially improving quality of life for people with diabetes (PwD) while reducing the costs of treating short- and long-term diabetes-related complications. However, many barriers to their use and regional inequalities remain in Central and Eastern Europe (CEE). Published data suggest that access to diabetes technologies is hindered by lack of funding, underdeveloped health technology assessment (HTA) bodies and guidelines, unfamiliarity with novel therapies, and inadequacies in healthcare system capacities. To optimize the use of diabetes technologies in CEE, an international meeting comprising experts in the field of diabetes was held to map the current regional access, to present the current national reimbursement guidelines, and to recommend solutions to overcome uptake barriers. Recommendations included regional and national development of HTA bodies, efficient allocation of resources, and structured education programs for healthcare professionals and PwD. The responsibility of the healthcare community to ensure that all individuals with T1D gain access to modern technologies in a timely and economically responsible manner, thereby improving health outcomes, was emphasized, particularly for interventions that are cost-effective.

3rd Department of Internal Medicine 1st Faculty of Medicine Charles University and General Faculty Hospital Prague Czechia

Department of Children and Adolescents Jessenius Faculty of Medicine Comenius University Bratislava Martin Slovakia

Department of Diabetes Nutrition and Metabolic Diseases Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Endocrinology Diabetes and Metabolic Diseases University Medical Center Ljubljana Zaloska 7 1000 Ljubljana Slovenia

Department of Endocrinology Medical University of Sofia Sofia Bulgaria

Department of Medicine and Oncology Semmelweis University Budapest Budapest Hungary

Department of Metabolic Diseases Jagiellonian University Medical College Krakow Poland

Faculty of Medicine of the University of Belgrade Clinic for Endocrinology Diabetes and Metabolic Diseases Clinical Center of Serbia Belgrade Serbia

Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Pediatric Department National Institute of Endocrinology and Diabetology Ľubochňa Slovakia

School of Medicine Josip Juraj Strossmayer University of Osijek Osijek Croatia

School of Medicine University of Zagreb Zagreb Croatia

Ukrainian Scientific and Practical Center of Endocrine Surgery Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine Kyiv Ukraine

University Hospital Kraków Poland

University Medical Center Ljubljana Ljubljana Slovenia

Vuk Vrhovac University Clinic for Diabetes Endocrinology and Metabolic Diseases Merkur University Hospital Zagreb Croatia

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