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Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis
The study aimed to evaluate the effectiveness and safety of long-term use of closed-loop insulin system (CLS) in non-pregnant patients with type 1 diabetes mellitus (T1DM) using systematic review and meta-analysis. A literature search was performed using MEDLINE, EMBASE, and the Cochrane Library. Ra...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024214/ https://www.ncbi.nlm.nih.gov/pubmed/35450868 http://dx.doi.org/10.1136/bmjdrc-2021-002633 |
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author | Jiao, Xiaojuan Shen, Yunfeng Chen, Yifa |
author_facet | Jiao, Xiaojuan Shen, Yunfeng Chen, Yifa |
author_sort | Jiao, Xiaojuan |
collection | PubMed |
description | The study aimed to evaluate the effectiveness and safety of long-term use of closed-loop insulin system (CLS) in non-pregnant patients with type 1 diabetes mellitus (T1DM) using systematic review and meta-analysis. A literature search was performed using MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials (RCTs) on long-term use (not less than 8 weeks) of CLS in patients with T1DM were selected. Meta-analysis was performed with RevMan V.5.3.5 to compare CLS with controls (continuous subcutaneous insulin infusion with blinded continuous glucose monitoring or unblinded sensor-augmented pump therapy or multiple daily injections or predictive low-glucose suspend system) in adults and children with type 1 diabetes. Research quality evaluation was conducted using the Cochrane risk of bias tool. Eleven RCTs (817 patients) that satisfied the eligibility criteria were included in the meta-analysis. Compared with controls, the CLS group had a favorable effect on the proportion of time with sensor glucose level in 3.9–10 mmol/L (10.32%, 8.70% to 11.95%), above 10 mmol/L (−8.89%, −10.57% to −7.22%), or below 3.9 mmol/L (−1.09%, −1.54% to −0.64%) over 24 hours. The CLS group also had lower glycated hemoglobin levels (−0.30%, −0.41% to −0.19%), and glucose variability, coefficient of variation of glucose, and SD were lower by 1.41 (−2.38 to −0.44, p=0.004) and 6.37 mg/dL (−9.19 mg/dL to −3.55 mg/dL, p<0.00001). There were no significant differences between the CLS and the control group in terms of daily insulin dose, quality of life assessment, and satisfaction with diabetes treatment. CLS is a better solution than control treatment in optimizing blood glucose management in patients with T1DM. CLS could become a common means of treating T1DM in clinical practice. |
format | Online Article Text |
id | pubmed-9024214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-90242142022-05-06 Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis Jiao, Xiaojuan Shen, Yunfeng Chen, Yifa BMJ Open Diabetes Res Care Emerging Technologies, Pharmacology and Therapeutics The study aimed to evaluate the effectiveness and safety of long-term use of closed-loop insulin system (CLS) in non-pregnant patients with type 1 diabetes mellitus (T1DM) using systematic review and meta-analysis. A literature search was performed using MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials (RCTs) on long-term use (not less than 8 weeks) of CLS in patients with T1DM were selected. Meta-analysis was performed with RevMan V.5.3.5 to compare CLS with controls (continuous subcutaneous insulin infusion with blinded continuous glucose monitoring or unblinded sensor-augmented pump therapy or multiple daily injections or predictive low-glucose suspend system) in adults and children with type 1 diabetes. Research quality evaluation was conducted using the Cochrane risk of bias tool. Eleven RCTs (817 patients) that satisfied the eligibility criteria were included in the meta-analysis. Compared with controls, the CLS group had a favorable effect on the proportion of time with sensor glucose level in 3.9–10 mmol/L (10.32%, 8.70% to 11.95%), above 10 mmol/L (−8.89%, −10.57% to −7.22%), or below 3.9 mmol/L (−1.09%, −1.54% to −0.64%) over 24 hours. The CLS group also had lower glycated hemoglobin levels (−0.30%, −0.41% to −0.19%), and glucose variability, coefficient of variation of glucose, and SD were lower by 1.41 (−2.38 to −0.44, p=0.004) and 6.37 mg/dL (−9.19 mg/dL to −3.55 mg/dL, p<0.00001). There were no significant differences between the CLS and the control group in terms of daily insulin dose, quality of life assessment, and satisfaction with diabetes treatment. CLS is a better solution than control treatment in optimizing blood glucose management in patients with T1DM. CLS could become a common means of treating T1DM in clinical practice. BMJ Publishing Group 2022-04-21 /pmc/articles/PMC9024214/ /pubmed/35450868 http://dx.doi.org/10.1136/bmjdrc-2021-002633 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Emerging Technologies, Pharmacology and Therapeutics Jiao, Xiaojuan Shen, Yunfeng Chen, Yifa Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
title | Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
title_full | Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
title_fullStr | Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
title_full_unstemmed | Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
title_short | Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
title_sort | better tir, hba1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis |
topic | Emerging Technologies, Pharmacology and Therapeutics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024214/ https://www.ncbi.nlm.nih.gov/pubmed/35450868 http://dx.doi.org/10.1136/bmjdrc-2021-002633 |
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