Automated Insulin Delivery for Minoritized and Non-Minoritized Populations with Type 1 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-09-30 DOI:10.1016/j.eprac.2025.09.198

Puguh Oktavian, Citrawati Dyah Kencono Wungu, Sony Wibisono Mudjanarko, Indah Mohd Amin

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引用次数: 0

Abstract

Objectives: Despite the efficacy of diabetes technologies, significant ethnic and racial disparities persist in the care and outcomes of individuals with type 1 diabetes. Therefore, this study evaluates the efficacy and safety of automated insulin delivery (AID) systems in non-minoritized (non-Hispanic White) and minoritized (Hispanic, non-Hispanic Black, Asian, and others) populations with type 1 diabetes.

Methods: We conducted a systematic review and meta-analysis of studies identified on PubMed, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov up to August 18, 2025. The primary outcome was the percentage of time-in-range (TIR; 3.9-10.0 mmol/L). Secondary outcomes included time-below-range (TBR), and glycated hemoglobin (HbA1c). Data were pooled as mean differences (MDs) with 95% confidence intervals (CIs).

Results: Twelve studies involving 327 participants from minoritized and 1,377 non-minoritized groups were included. AID systems significantly improved TIR in both minoritized (MD 13.90% [95% CI 9.64 to 18.16], I² = 20%, p < 0.0001; high certainty) and non-minoritized groups (MD 10.66% [95% CI 9.12 to 12.21], I² = 15%, p < 0.0001; high certainty). Favorable effects were observed on HbA1c for both minoritized (MD -0.49% [95% CI -0.69 to -0.29]) and non-minoritized groups (MD -0.34% [95% CI -0.46 to -0.23]). No significant increase in severe hypoglycemia or diabetic ketoacidosis was observed.

Conclusions: The AID systems improve glycemic outcomes in minoritized and non-minoritized populations with type 1 diabetes and have good safety profiles. AID systems hold promise for reducing racial and ethnic disparities in diabetes care and outcomes.

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1型糖尿病少数和非少数人群的自动胰岛素输送：随机对照试验的系统回顾和荟萃分析

目的：尽管糖尿病技术有效，但1型糖尿病患者的护理和预后仍然存在显著的民族和种族差异。因此，本研究评估了自动胰岛素输送（AID）系统在非少数族裔（非西班牙裔白人）和少数族裔（西班牙裔、非西班牙裔黑人、亚洲人和其他）1型糖尿病患者中的有效性和安全性。方法：我们对PubMed、Scopus、Web of Science、Cochrane Library和ClinicalTrials.gov上截至2025年8月18日的研究进行了系统回顾和荟萃分析。主要终点为范围内时间百分比（TIR; 3.9-10.0 mmol/L）。次要结局包括时间低于范围（TBR）和糖化血红蛋白（HbA1c）。数据以95%置信区间（ci）的平均差异（md）合并。结果：纳入了12项研究，涉及327名来自少数族裔和1377名非少数族裔的参与者。AID系统显著提高了少数群体（MD 13.90% [95% CI 9.64 ~ 18.16], I2 = 20%, p < 0.0001，高确定性）和非少数群体（MD 10.66% [95% CI 9.12 ~ 12.21], I2 = 15%, p < 0.0001，高确定性）的TIR。在少数组（MD -0.49% [95% CI -0.69至-0.29]）和非少数组（MD -0.34% [95% CI -0.46至-0.23]）中均观察到良好的HbA1c效果。严重低血糖或糖尿病酮症酸中毒未见明显增加。结论：AID系统改善了少数和非少数1型糖尿病患者的血糖结局，并且具有良好的安全性。艾滋病系统有望减少糖尿病治疗和结果方面的种族和民族差异。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.