Does fully closed‐loop automated insulin delivery improve glycaemic control in patients with type 2 diabetes? A meta‐analysis of randomized controlled trials
Pooled result · Time in target glucose range per 24 hResult — go to the resultMD 23.39 % 95% CI 16.64%–30.14%Authors' conclusion
Our meta-analysis suggests that fully closed-loop AID may improve glycaemic control in patients with type 2 diabetes, particularly for those with more challenging diabetes management. Further research is required to establish the feasibility of implementing these systems in clinical practice. [Correction added on 26 August 2023 after first online publication: Under Results, the first sentence "We included seven RCTs (three crossover and one parallel designs)" has been changed to "We included seven RCTs (three crossover and four parallel designs)".].
Study context
- Population
- Patients with T2D; Randomized Controlled Trials (RCTs) from PubMed, Scopus, Web of Science and Cochrane Central to April 26, 2023
- Participants
- 390 patients7 RCTs
- Comparison
- Fully closed-loop automated insulin delivery (AID) vs conventional insulin therapy
- Outcome
- Proportion of time in target glucose range (5.6-10 mmol/L, 3.9-10 mmol/L, or 3.9-8 mmol/L, depending on the study)
Methodological detailsrandom effect model, three crossover and four parallel design RCTs
- Random effect model
- Three crossover and four parallel design RCTs
Pooled result
Time in target glucose range per 24 h
MD
23.39 %
95% CI 16.64%–30.14%
P < 0.01
As reported in the abstract
Further pooled results
| Outcome | MD (%) (95% CI) | P value | |
|---|---|---|---|
| Proportion of time in target glucose range, overnightAdditional 108 min overnight · random effect model | 22.40 (12.88%–31.91%) | P < 0.01 | |
| Proportion of time in target glucose range, daytimeAdditional 258 min during the daytime · random effect model | 26.85 (21.06%–32.63%) | P < 0.01 | |
| −2002040Difference, % (linear scale) |
Overall time in hyperglycaemia · per 24 h
- Overall time in hyperglycaemia vs control: shortened by 326 min per 24 h
- MD = −22.67%, 95% CI [−30.87%, −14.46%], p < 0.01
- Random effect model
Time in hypoglycaemia (overall, overnight, daytime)
- No significant difference between the two groups in overall, overnight and daytime periods spent in hypoglycaemia
Safety
- No significant difference between the two groups in overall, overnight and daytime time in hypoglycaemia
Original publication
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