Glycemic and psychosocial outcomes of automated insulin delivery in older and high-risk populations with type 1 diabetes: a systematic review and meta-analysis
Authors' conclusion
Automated insulin delivery exhibits favorable glycemic outcomes and safety profiles in older and high-risk individuals with type 1 diabetes, suggesting potential benefits for populations traditionally considered vulnerable, although no significant improvements were observed in psychosocial outcomes.
Study context
- Population
- Older adults (≥60 years) and high-risk individuals with T1D (impaired awareness of hypoglycaemia, cognitive or functional impairment)
- Participants
- 967 adults23 studies
- Comparison
- Automated insulin delivery (AID) vs comparator
- Outcome
- TIR (3.9-10.0 mmol/L [70-180 mg/dL])
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
TIR
AID increased TIR by
11.38%
95% CI 8.07–14.70; I2 = 70%; P < .0001; equivalent to 2.7 hours/day
Further pooled results
TIR during the day
- TIR improvement during the day
- 8.70% (95% CI 5.18-12.22%)
TIR overnight
- TIR improvement overnight
- 13.35% (95% CI 11.07-15.62%)
Commercial vs noncommercial systems
- Favorable improvement comparable among commercial and noncommercial systems
Time in hyperglycaemia
- AID reduced time in hyperglycemia
- −7.89%
Time in hypoglycaemia
- AID reduced time in hypoglycemia
- −1.16%
Psychosocial well-being
- No significant differences in psychosocial well-being
Safety
DKA and severe hypoglycaemia
- DKA and severe hypoglycemia events were not significant
Original publication
Glycemic and psychosocial outcomes of automated insulin delivery in older and high-risk populations with type 1 diabetes: a systematic review and meta-analysis. J Clin Endocrinol Metab. Published 30 September 2026. doi:10.
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