Automated Insulin Delivery Systems in Children and Adolescents With Type 1 Diabetes: A Systematic Review and Meta-analysis of Outpatient Randomized Controlled Trials

Author:

Zeng Baoqi12ORCID,Gao Le3,Yang Qingqing2,Jia Hao4,Sun Feng25

Affiliation:

1. 1Central Laboratory, Peking University Binhai Hospital, Tianjin, China

2. 2Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China

3. 3Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China

4. 4Drug Clinical Trial Institution, Peking University Binhai Hospital, Tianjin, China

5. 5Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Health, Beijing, China

Abstract

BACKGROUND The glycemic control of automated insulin delivery (AID) systems in outpatient children and adolescents with type 1 diabetes (T1D) has not been systematically evaluated. PURPOSE To evaluate the efficacy and safety of AID systems in children and adolescents in outpatient settings. DATA SOURCES PubMed, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched until 4 May 2023. This study was registered with PROSPERO (2023, CRD42023395252). STUDY SELECTION Randomized controlled trials that compared AID systems with conventional insulin therapy in outpatient children and adolescents with T1D and reported continuous glucose monitoring outcomes were selected. DATA EXTRACTION Percent time in range (TIR) (3.9–10 mmol/L), time below range (TBR) (<3.9 mmol/L), and time above range (TAR) (>10 mmol/L) were extracted. Data were summarized as mean differences (MDs) with 95% CIs. DATA SYNTHESIS Twenty-five trials (1,345 participants) were included in the meta-analysis. AID systems were associated with an increased percentage of TIR (MD, 11.38% [95% CI 9.01–13.76], P < 0.001; high certainty). The favorable effect was consistent whether AID was used over 3 months (10.46% [8.71–12.20]) or 6 months (10.87% [7.11–14.63]). AID systems had a favorable effect on the proportion of TBR (−0.59% [−1.02 to −0.15], P = 0.008; low certainty) or TAR (−12.19% [−14.65 to −9.73], P < 0.001; high certainty) compared with control treatment. LIMITATIONS Substantial heterogeneity was observed in most analyses. CONCLUSIONS AID systems are more effective than conventional insulin therapy for children and adolescents with T1D in outpatient settings. The favorable effect is consistent both in the short term and long term.

Funder

National Natural Science Foundation of China

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference36 articles.

1. Type 1 diabetes;DiMeglio;Lancet,2018

2. International Diabetes Federation . IDF Diabetes Atlas, 10th edition. Brussels, Belgium, International Diabetes Foundation, 2021. Accessed 13 March 2023. Available from https://diabetesatlas.org/atlas/tenth-edition/

3. 13. Children and Adolescents: Standards of Medical Care in Diabetes—2020;American Diabetes Association;Diabetes Care,2020

4. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range;Battelino;Diabetes Care,2019

5. The relationship of hemoglobin A1C to time-in-range in patients with diabetes;Vigersky;Diabetes Technol Ther,2019

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