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Publications

Journal Article Review Ahead of print

PubMed: 40505729 DOI: 10.1016/j.eprac.2025.06.004

A Review of Real-World Evidence About the Use of Automated Insulin Delivery Systems in People With Type 1 Diabetes.

Endocr Pract

Authors: Sonia Gera, Jaisree Iyer, Seema Meighan, Christine A March, Brynn E Marks

Affiliations

  • Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Division of Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
  • Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

INTRODUCTION

Automated insulin delivery systems (AID) have revolutionized type 1 diabetes (T1D) management. Guidelines support offering AID to all people with T1D and engaging in shared decision making when choosing among the available AID systems.

RESULTS

In clinical trials, AID has been shown to improve glycemic control and reduce hypoglycemia while also improving quality of life. However, participants in clinical trials do not accurately reflect the entire T1D population and outcomes from these controlled may not generalize to clinical care. A growing body of real-world evidence seeks to understand the effect of AID systems on glycemia and person-reported outcome measures in real-world populations. These real-world studies highlight the effect of differences in engagement with AID, including time in automated mode and boluses per day, considerations about AID system selection, and approaches to educate people with T1D.

CONCLUSION

In this review, we compare glycemic and person reported outcomes in clinical trials and the real-world studies, with consideration of the effects of different systems according to user characteristics. We also review the current state of device selection and education for people with diabetes, their caregivers, and clinicians. Lastly, we summarize key findings across AID systems and opportunities for further research.

MeSH

Diabetes Mellitus, Insulin, Diabetes Mellitus, Type 1, Endocrine System Diseases, Glycemic Control