Gera Sonia, Iyer Jaisree, Meighan Seema, March Christine A, Marks Brynn E
Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Division of Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Endocr Pract. 2025 Jun 10. doi: 10.1016/j.eprac.2025.06.004.
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.
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.
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.
自动胰岛素输送系统（AID）彻底改变了1型糖尿病（T1D）的管理方式。指南支持为所有T1D患者提供AID，并在现有AID系统中进行选择时参与共同决策。
在临床试验中，AID已被证明可改善血糖控制、降低低血糖风险，同时还能提高生活质量。然而，临床试验的参与者并不能准确反映整个T1D人群，这些对照试验的结果可能无法推广到临床护理中。越来越多的真实世界证据试图了解AID系统对真实世界人群血糖和患者报告结局指标的影响。这些真实世界研究突出了使用AID的差异所产生的影响，包括自动模式下的时间和每日大剂量注射次数、AID系统选择的考量因素，以及对T1D患者的教育方法。
在本综述中，我们比较了临床试验和真实世界研究中的血糖及患者报告结局，并根据用户特征考虑了不同系统的影响。我们还回顾了糖尿病患者、其护理人员和临床医生在设备选择和教育方面的现状。最后，我们总结了AID系统的关键发现以及进一步研究的机会。
