Impact of stepwise diabetes technology advances in older adults with type 1 diabetes: A systematic review and meta‐analysis of randomised trials
Authors' conclusion
Advancing to higher-level technologies for glucose monitoring and insulin delivery significantly and safely improve glycemic control in older adults with T1D. Physiological age alone should not be a primary barrier to prescribing these technologies, particularly for carefully selected older adults.
Study context
- Population
- Older adults aged ≥60 years with T1D in randomised controlled trials (RCTs); mean age 69.2 years, mean T1D duration 36.1 years
- Participants
- 482 adults5 RCTs
- Comparison
- Higher-level vs lower-level diabetes technology
- Outcome
- Co-primary: TBR <3.9 mmol/L (TBR3.9) and TIR 3.9-10.0 mmol/L
Methodological detailspre-specified domain comparisons (AID vs lower-level insulin delivery; CGM vs SMBG), Three crossover trials contributed to the AID comparison, two parallel trials to the CGM comparison
- Pre-specified domain comparisons (AID vs lower-level insulin delivery; CGM vs SMBG)
- Three crossover trials contributed to the AID comparison, two parallel trials to the CGM comparison
Pooled result
As reported in the abstract
Each group vs lower-level technologiesMD (TBR3.9), % (95% CI)P value
Higher-level technologies
−0.62(−1.02 to −0.22)
P = 0.002- Higher-level technologies
- MD (TIR) +7.90 % (95% CI 7.09–8.72); P < 0.001
Further pooled results
TBR <3.0 mmol/L, TAR >10.0 and >13.9 mmol/L, HbA1c, glycemic variability
- Benefits observed with higher-level technologies (all p <0.05)
Safety
| Outcome | Peto OR (95% CI) | P value | |
|---|---|---|---|
| Severe hypoglycaemiaNNT = 20 | 0.16 (0.06–0.41) | P < 0.001 | |
| DKANo significant increase | 3.72 (0.75–18.49) | P = 0.11 | |
| 0.050.21520Peto OR (log scale) |
Original publication
Impact of stepwise diabetes technology advances in older adults with type 1 diabetes: A systematic review and meta‐analysis of randomised trials. Diabetes Obes Metab. Published 12 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →