A retrospective observational study evaluating the safety and effectiveness of commercially available automated insulin delivery systems in people with type 1 diabetes and gastroparesis
Authors' conclusion
Within a specialist multidisciplinary team setting, HCL systems significantly reduce HbA1c without increasing risk of severe hypoglycaemia or DKA in people with type 1 diabetes and gastroparesis.
Study context
- Population
- Adults with T1D and gastroparesis using continuous glucose monitoring (CGM), King's College Hospital diabetes service, 5 October 2023 to 16 January 202517 initiated HCL
- Participants
- 36 adults
- Exposure
- HCL vs non-HCL
- HCLn = 17
- Outcome
- HbA1c post-HCL vs baseline (HCL)
- Follow-up
- 12 months pre- and post-HCL initiation
Methodological detailsobservational, real-world, single-centre
- Observational
- Real-world
- Single-centre
Main finding
As reported in the abstract
- Baseline HbA1c in HCL, mean (SD)
- 70(21)mmol/mol [8.6(1.9)%]
- Post-HCL HbA1c, median (IQR)
- 57(52.5-65.0) mmol/mol [7.4(7.0-8.1)%]
- Change pre- to post-HCL
- p < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HCL | non-HCL | P value |
|---|---|---|---|
| Baseline characteristics and metricsComparable baseline characteristics and metrics | Mean 70 (SD 21) mmol/mol | 71 (SD 25) mmol/mol | P = 0.73 |
| HbA1c % | 8.6(1.9)% | 8.6(2.3)% | |
| TIR | 36.8 (21.9) % | 37.1(19.2)% |
Time in range (TIR) post-HCL
- TIR increased to (mean (SD))
- 55.7(19.9)%
- P
- P < 0.001
TAR Level 2 (>13.9 mmol/L/>250 mg/dL) post-HCL
- Significant reduction
- 32.7% to 14.5%
- P
- P = 0.014
Hypoglycaemia awareness (Gold score) post-HCL
- Improved
- 2.5 to 1.5
- P
- P = 0.019
Diabetes distress (DDS2)
- DDS2 remained unchanged
Safety
- No increase in DKA or severe hypoglycaemia occurred
Original publication
A retrospective observational study evaluating the safety and effectiveness of commercially available automated insulin delivery systems in people with type 1 diabetes and gastroparesis. Diabetes Obes Metab. Published 19 February 2026. doi:10.
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