Efficacy and Safety of Tubeless Hybrid Closed‐Loop Systems in Type 1 Diabetes: A Meta‐Analysis of Randomized Controlled Trials
Authors' conclusion
The available evidence suggests that tubeless HCL systems may improve glycaemic control without increasing insulin dose or short-term safety risks.
Study context
- Population
- People with T1D; mean age 32.3 ± 15.7 years, mean T1D duration 14.7 ± 11.1 years, mean baseline HbA1c 8.0% ± 1.0%
- Participants
- 514 people4 randomized controlled trials (RCTs)
- Comparison
- Tubeless hybrid closed-loop (HCL) systems vs standard care
- Outcome
- TIR 3.9-10.0 mmol/L and HbA1c
Methodological detailsrandom- or fixed-effects models
- Random- or fixed-effects models
Pooled result
As reported in the abstract
Tubeless HCL vs SCMD, % (95% CI)P value
TIR; I 2 = 95%
15.31(7.67%–22.95%)
P < 0.001HbA1c; I 2 = 91%
−0.46(−0.79% to −0.14%)
P = 0.005Further pooled results
| Outcome | P value |
|---|---|
| TAR (TAR10.0, TAR13.9), TBR3.9 and CV | all p < 0.001 |
TAR (TAR10.0, TAR13.9), TBR3.9 and coefficient of variability (CV)
- Lower TAR (TAR10.0, TAR13.9), TBR3.9 and CV with tubeless HCL
TBR3.0
- No significant difference in TBR3.0
Insulin dose
- No significant difference in insulin dose
Safety
- Diabetic ketoacidosis (DKA) and severe hypoglycaemia (SH) events were rare in both groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Efficacy and Safety of Tubeless Hybrid Closed‐Loop Systems in Type 1 Diabetes: A Meta‐Analysis of Randomized Controlled Trials. Diabetes Obes Metab. Published 6 July 2026. doi:10.
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