Fully automated insulin delivery systems in type 1 diabetes: A systematic review and meta‐analysis

作者：Wenqi Fan, Chao Deng, Ruoyao Xu, Zhenqi Liu, Yuhu He, Zhiguang Zhou, Xia Li · 发表于：Diabetes Obesity and Metabolism · 年份：2025 · DOI：10.1111/dom.16499 · 被引用次数：8 · 研究领域：Diabetes Management and Research、Pancreatic function and diabetes、Hyperglycemia and glycemic control in critically ill and hospitalized patients

AIMS: The landscape of insulin delivery is evolving, transitioning from hybrid automated insulin delivery (AID) to more sophisticated fully AID systems. We aimed to compare the efficacy of fully AID systems with any insulin delivery method in type 1 diabetes (T1D). MATERIALS AND METHODS: Following registration in PROSPERO, CRD42024528669, PubMed, Embase, Cochrane Library and Web of Science were searched up to 26 February 2025 for randomised clinical trials comparing fully AID systems to any insulin delivery method in T1D. The control treatments included conventional insulin therapy (multiple daily injections, continuous subcutaneous insulin infusion and sensor-augmented pumps) and hybrid AID systems. The primary outcome was the mean difference (MD) in the percentage of time blood glucose concentration remained in the target range (3.9-10.0 mmol/L or 4.0-10.0 mmol/L), assessed by random-effects models. RESULTS: We identified 1308 reports; after exclusions, 16 trials (669 patients) were included. Time in range (TIR) was higher using fully AID systems than control treatments (MD 9.99% [95% confidence interval, 3.75% to 16.22%], p = 0.002). This improvement was accompanied by increased diabetes treatment satisfaction (MD 3.70 points [95% confidence interval, 0.22 points to 7.18 points], p = 0.04). Fully AID systems exhibited a favourable effect on TIR when compared with conventional insulin therapy, while exhibiting an opposite effect when compared with hybrid AID (17.44% vs. -3....