Does fully closed‐loop automated insulin delivery improve glycaemic control in patients with type 2 diabetes? A meta‐analysis of randomized controlled trials

Aims This meta‐analysis investigated the efficacy and safety of fully closed‐loop automated insulin delivery (AID) in patients with type 2 diabetes. Materials and Methods We systemically searched PubMed, Scopus, Web of Science, and Cochrane Central from inception until April 26, 2023. We included randomized controlled trials (RCTs) comparing fully closed‐loop AID versus conventional insulin therapy. The outcomes were pooled as the mean difference (MD) and risk ratio with 95% confidence interval (CI) in the random effect model. Our primary outcome was the proportion of time in the target glucose range (5.6‐10 mmol/L, 3.9‐10 mmol/L, or 3.9‐8 mmol/L, depending on the study). Key secondary outcomes included the proportion of time spent in hyperglycaemia or hypoglycaemia. Results We included seven RCTs (three crossover and four parallel design), compromising 390 patients. Our analysis showed that compared to the control group, fully closed‐loop AID increased the proportion of time spent within the target glucose range by additional 337 min per 24 h (MD = 23.39%, 95% CI [16.64%, 30.14%], p