Comparative Efficacy of Insulin Delivery Modalities on Glycaemic Control in Adults With Type 2 Diabetes: A Systematic Review and Network Meta‐Analysis
Authors' conclusion
HCL showed the most consistent glycaemic benefit, but body-weight and sparse safety evidence warrant caution.
Study context
- Population
- Adults with insulin-treated T2D
- Participants
- 4,157 adults36 trials
- Comparison
- Insulin delivery modalities vs multiple daily injections (MDI)
- Outcome
- Change in HbA1c
- Follow-up
- Median 12 weeks
Methodological detailsparallel-group randomised trials, primary analysis excluding residual Other node, CINeMA certainty assessment, Most trials had risk-of-bias concerns; low-risk sensitivity analysis infeasible
- Parallel-group randomised trials
- Primary analysis excluding residual Other node
- CINeMA certainty assessment
- Most trials had risk-of-bias concerns; low-risk sensitivity analysis infeasible
Pooled result
As reported in the abstract
Each group vs MDIMD, % (95% CI)
HCL
−0.79(−1.33 to −0.25)
Continuous subcutaneous insulin infusion
−0.47(−0.74 to −0.20)
Further pooled results
| Outcome | MD (percentage points) (95% CI) | |
|---|---|---|
| TARHCLvs MDI | −13.48 (−23.05 to −3.91) | |
| −30−20−10010Difference, percentage points (linear scale) |
| Outcome | MD (U/day) (95% CI) | |
|---|---|---|
| Insulin doseHCLvs MDI | −15.69 (−31.33 to −0.06) | |
| −40−20020Difference, U/day (linear scale) |
| Outcome | MD (percentage points) (95% CI) |
|---|---|
| TIRHCL vs MDI | +16.00 (+8.77 to +23.22) |
Time in range (TIR)
- Fully closed-loop yielded larger TIR/time above range (TAR) estimates, from one short trial only; hypothesis-generating
Insulin dose
- Continuous subcutaneous insulin infusion also reduced insulin dose
Safety
| Outcome | MD (kg) (95% CI) |
|---|---|
| Body weightHCL vs MDI | +1.58 (+0.75 to +2.40) |
Original publication
Comparative Efficacy of Insulin Delivery Modalities on Glycaemic Control in Adults With Type 2 Diabetes: A Systematic Review and Network Meta‐Analysis. Diabetes Obes Metab. Published 13 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →