Sergio Di Molfetta, Ludovico Di Gioia, Irene Caruso, Mariangela Caporusso, Paolo Trerotoli, Annalisa Natalicchio, Sebastio Perrini, Luigi Laviola, Francesco Giorgino
{"title":"1型糖尿病患者不同市售混合闭环系统的血糖控制和变异性：随机对照试验的系统回顾和荟萃分析","authors":"Sergio Di Molfetta, Ludovico Di Gioia, Irene Caruso, Mariangela Caporusso, Paolo Trerotoli, Annalisa Natalicchio, Sebastio Perrini, Luigi Laviola, Francesco Giorgino","doi":"10.1111/dom.70150","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To provide an updated analysis of the performance of different hybrid closed loop (HCL) systems in randomised controlled trials (RCTs) on subjects with type 1 diabetes.</p><p><strong>Materials and methods: </strong>We conducted a systematic review with meta-analysis. We searched four online databases and performed hand-searching of conference proceedings to find studies from inception to 18 April 2025. We included RCTs enrolling subjects with type 1 diabetes, evaluating commercial HCL systems against other insulin therapy regimens, with a duration of intervention ≥2 weeks, and reporting time in range (TIR) as an outcome. Studies involving pregnant women were excluded.</p><p><strong>Results: </strong>A total of 37 studies evaluating seven different HCL systems (CamAPS Fx, Control IQ, DBLG1, iLet BP, MiniMed 670G, MiniMed 780G, and Omnipod 5) were included. In studies with a mean age < 18 years, mean TIR was 64.1% (95% CI: 61-67.2), ranging from 59.3% (95% CI: 49.6-69.1) with MiniMed 780G to 68% (95% CI: 65.8-70.3) with Control IQ, and end-of-study HbA1c was 7.4% (95% CI: 7-7.7), ranging from 6.7% (95% CI: 6.6-6.9) with CamAPS Fx to 7.9% (95% CI: 6.9-9) with MiniMed 780G. In studies with a mean age ≥ 18 years, mean TIR was 70.8% (95% CI: 68.6-73), ranging from 63.1% (95% CI: 59.4-66.8) with Omnipod 5 to 74.4% (95% CI: 69.7-79.1) with MiniMed 780G, and end-of-study HbA1c was 7.1% (95% CI: 7-7.3), ranging from 7.0% (95% CI: 6.9-7.1) with Control IQ to 7.2% (95% CI: 7-7.5) with MiniMed 670G.</p><p><strong>Conclusions: </strong>In RCTs, commercial HCL systems show different achievements of CGM metrics and HbA1c in people with type 1 diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Glycaemic control and variability with different commercially available hybrid closed loop systems in people with type 1 diabetes: A systematic review and meta-analysis of randomized controlled trials.\",\"authors\":\"Sergio Di Molfetta, Ludovico Di Gioia, Irene Caruso, Mariangela Caporusso, Paolo Trerotoli, Annalisa Natalicchio, Sebastio Perrini, Luigi Laviola, Francesco Giorgino\",\"doi\":\"10.1111/dom.70150\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To provide an updated analysis of the performance of different hybrid closed loop (HCL) systems in randomised controlled trials (RCTs) on subjects with type 1 diabetes.</p><p><strong>Materials and methods: </strong>We conducted a systematic review with meta-analysis. We searched four online databases and performed hand-searching of conference proceedings to find studies from inception to 18 April 2025. We included RCTs enrolling subjects with type 1 diabetes, evaluating commercial HCL systems against other insulin therapy regimens, with a duration of intervention ≥2 weeks, and reporting time in range (TIR) as an outcome. Studies involving pregnant women were excluded.</p><p><strong>Results: </strong>A total of 37 studies evaluating seven different HCL systems (CamAPS Fx, Control IQ, DBLG1, iLet BP, MiniMed 670G, MiniMed 780G, and Omnipod 5) were included. In studies with a mean age < 18 years, mean TIR was 64.1% (95% CI: 61-67.2), ranging from 59.3% (95% CI: 49.6-69.1) with MiniMed 780G to 68% (95% CI: 65.8-70.3) with Control IQ, and end-of-study HbA1c was 7.4% (95% CI: 7-7.7), ranging from 6.7% (95% CI: 6.6-6.9) with CamAPS Fx to 7.9% (95% CI: 6.9-9) with MiniMed 780G. In studies with a mean age ≥ 18 years, mean TIR was 70.8% (95% CI: 68.6-73), ranging from 63.1% (95% CI: 59.4-66.8) with Omnipod 5 to 74.4% (95% CI: 69.7-79.1) with MiniMed 780G, and end-of-study HbA1c was 7.1% (95% CI: 7-7.3), ranging from 7.0% (95% CI: 6.9-7.1) with Control IQ to 7.2% (95% CI: 7-7.5) with MiniMed 670G.</p><p><strong>Conclusions: </strong>In RCTs, commercial HCL systems show different achievements of CGM metrics and HbA1c in people with type 1 diabetes.</p>\",\"PeriodicalId\":158,\"journal\":{\"name\":\"Diabetes, Obesity & Metabolism\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2025-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes, Obesity & Metabolism\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/dom.70150\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes, Obesity & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dom.70150","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Glycaemic control and variability with different commercially available hybrid closed loop systems in people with type 1 diabetes: A systematic review and meta-analysis of randomized controlled trials.
Aims: To provide an updated analysis of the performance of different hybrid closed loop (HCL) systems in randomised controlled trials (RCTs) on subjects with type 1 diabetes.
Materials and methods: We conducted a systematic review with meta-analysis. We searched four online databases and performed hand-searching of conference proceedings to find studies from inception to 18 April 2025. We included RCTs enrolling subjects with type 1 diabetes, evaluating commercial HCL systems against other insulin therapy regimens, with a duration of intervention ≥2 weeks, and reporting time in range (TIR) as an outcome. Studies involving pregnant women were excluded.
Results: A total of 37 studies evaluating seven different HCL systems (CamAPS Fx, Control IQ, DBLG1, iLet BP, MiniMed 670G, MiniMed 780G, and Omnipod 5) were included. In studies with a mean age < 18 years, mean TIR was 64.1% (95% CI: 61-67.2), ranging from 59.3% (95% CI: 49.6-69.1) with MiniMed 780G to 68% (95% CI: 65.8-70.3) with Control IQ, and end-of-study HbA1c was 7.4% (95% CI: 7-7.7), ranging from 6.7% (95% CI: 6.6-6.9) with CamAPS Fx to 7.9% (95% CI: 6.9-9) with MiniMed 780G. In studies with a mean age ≥ 18 years, mean TIR was 70.8% (95% CI: 68.6-73), ranging from 63.1% (95% CI: 59.4-66.8) with Omnipod 5 to 74.4% (95% CI: 69.7-79.1) with MiniMed 780G, and end-of-study HbA1c was 7.1% (95% CI: 7-7.3), ranging from 7.0% (95% CI: 6.9-7.1) with Control IQ to 7.2% (95% CI: 7-7.5) with MiniMed 670G.
Conclusions: In RCTs, commercial HCL systems show different achievements of CGM metrics and HbA1c in people with type 1 diabetes.
期刊介绍：
Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.
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