Diabetes, obesity & metabolism · 2026
Efficacy and Safety of Automated Insulin Delivery in People With Type 2 Diabetes: A Systematic Review and Meta-Analysis.
Систематический обзорСтатьяМетаанализНазвание и аннотация: Перевод в очереди
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Di Molfetta Sergio, Di Gioia Ludovico, Caruso Irene, Caporusso Mariangela, Perrini Sebastio, Natalicchio Annalisa, Laviola Luigi, Giorgino Francesco
Аннотация
AIMS: Studies evaluating automated insulin delivery (AID) in type 2 diabetes are limited in number and often conducted in small cohorts. We aimed to summarize efficacy and safety data through a systematic review and meta-analysis.
MATERIALS AND METHODS: We searched MEDLINE, PubMed, Web of Science, and CENTRAL databases and performed hand searching until July 1, 2025. We included randomized controlled trials enrolling individuals with type 2 diabetes, evaluating AID against other glucose-lowering treatments, and reporting 24-h time spent in the 70-180 mg/dL glucose range (TIR 70-180 mg/dL) as an outcome. Risk of bias was assessed through the RoB2 tool.
RESULTS: A total of nine studies, accounting for 714 adults with type 2 diabetes, were included. AID was associated with improved TIR 70-180 mg/dL (mean difference [MD] 18.43%, 95% confidence interval [CI]: 12.40 to 24.46; low certainty), time above range (TAR; low certainty), TAR > 250 mg/dL, mean glucose, standard deviation (moderate certainty), and HbA1c (moderate certainty) compared to controls, without differences in time below range (TBR; moderate certainty), TBR < 54 mg/dL, and coefficient of variation. Despite similar total daily insulin doses, AID led to a modest gain in body weight (MD 1.58 kg; 95% CI: 0.75 to 2.40) compared to controls. Severe adverse events, including severe hypoglycemia, were rare. No episodes of diabetic ketoacidosis were reported.
CONCLUSIONS: In individuals with type 2 diabetes, AID is associated with short-term improvements in glycemic control, although the certainty of evidence is low to moderate.
TRAIL REGISTRATION: PROSPERO 2025 CRD420251083874.
MATERIALS AND METHODS: We searched MEDLINE, PubMed, Web of Science, and CENTRAL databases and performed hand searching until July 1, 2025. We included randomized controlled trials enrolling individuals with type 2 diabetes, evaluating AID against other glucose-lowering treatments, and reporting 24-h time spent in the 70-180 mg/dL glucose range (TIR 70-180 mg/dL) as an outcome. Risk of bias was assessed through the RoB2 tool.
RESULTS: A total of nine studies, accounting for 714 adults with type 2 diabetes, were included. AID was associated with improved TIR 70-180 mg/dL (mean difference [MD] 18.43%, 95% confidence interval [CI]: 12.40 to 24.46; low certainty), time above range (TAR; low certainty), TAR > 250 mg/dL, mean glucose, standard deviation (moderate certainty), and HbA1c (moderate certainty) compared to controls, without differences in time below range (TBR; moderate certainty), TBR < 54 mg/dL, and coefficient of variation. Despite similar total daily insulin doses, AID led to a modest gain in body weight (MD 1.58 kg; 95% CI: 0.75 to 2.40) compared to controls. Severe adverse events, including severe hypoglycemia, were rare. No episodes of diabetic ketoacidosis were reported.
CONCLUSIONS: In individuals with type 2 diabetes, AID is associated with short-term improvements in glycemic control, although the certainty of evidence is low to moderate.
TRAIL REGISTRATION: PROSPERO 2025 CRD420251083874.