Peacock Sofia, Frizelle Isolda, Hussain Sufyan
Department of Diabetes, School of Cardiovascular, Metabolic Medicine and Sciences, King's College London, London, UK.
Department of Diabetes and Endocrinology, Guy's & St Thomas' NHS Foundation Trust, King's College London, 3rd Floor Lambeth Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Diabetes Ther. 2023 May;14(5):839-855. doi: 10.1007/s13300-023-01394-5. Epub 2023 Apr 5.
Several different forms of automated insulin delivery systems (AID systems) have recently been developed and are now licensed for type 1 diabetes (T1D). We undertook a systematic review of reported trials and real-world studies for commercial hybrid closed-loop (HCL) systems.
Pivotal, phase III and real-world studies using commercial HCL systems that are currently approved for use in type 1 diabetes were reviewed with a devised protocol using the Medline database.
Fifty-nine studies were included in the systematic review (19 for 670G; 8 for 780G; 11 for Control-IQ; 14 for CamAPS FX; 4 for Diabeloop; and 3 for Omnipod 5). Twenty were real-world studies, and 39 were trials or sub-analyses. Twenty-three studies, including 17 additional studies, related to psychosocial outcomes and were analysed separately.
These studies highlighted that HCL systems improve time In range (TIR) and arouse minimal concerns around severe hypoglycaemia. HCL systems are an effective and safe option for improving diabetes care. Real-world comparisons between systems and their effects on psychological outcomes require further study.
最近已开发出几种不同形式的自动胰岛素输送系统(AID系统),目前已获1型糖尿病(T1D)许可。我们对已报道的商用混合闭环(HCL)系统的试验和真实世界研究进行了系统评价。
使用Medline数据库,按照设计的方案对目前已获批用于1型糖尿病的商用HCL系统的关键、III期和真实世界研究进行了综述。
系统评价纳入了59项研究(670G的研究19项;780G的研究8项;Control-IQ的研究11项;CamAPS FX的研究14项;Diabeloop的研究4项;Omnipod 5的研究3项)。20项为真实世界研究,39项为试验或亚分析。23项研究(包括另外17项研究)与心理社会结局相关,另行分析。
这些研究强调,HCL系统可改善血糖达标时间(TIR),并引发对严重低血糖的担忧最少。HCL系统是改善糖尿病护理的有效且安全的选择。系统之间的真实世界比较及其对心理结局的影响需要进一步研究。