Artificial Pancreas Systems: Efficacy Of Closed-Loop Systems In Type 1 Diabetes: A Systematic Review
Abstract
Background: Type 1 diabetes mellitus (T1D) is a chronic autoimmune condition requiring lifelong insulin therapy. Despite advances in insulin delivery, achieving near-physiological glucose control remains challenging due to glycemic variability and hypoglycemia risk. Closed-loop artificial pancreas (AP) systems integrate continuous glucose monitoring, insulin pumps, and automated algorithms to maintain glucose within target ranges.
Objective: To systematically evaluate the efficacy and safety of closed-loop insulin delivery systems in individuals with T1D, focusing on glycemic outcomes, time-in-range (TIR), HbA1c reduction, and adverse events.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between 2010 and 2025. Randomized controlled trials, crossover trials, and single-arm intervention studies assessing closed-loop or hybrid AP systems in T1D populations were included. Data extraction focused on study design, participant characteristics, algorithm type, glycemic outcomes, and safety.
Results: Ten studies encompassing 14–124 participants aged 6–75 years met inclusion criteria. Closed-loop systems consistently improved TIR by 6–15 percentage points, reduced HbA1c by 0.3–0.6%, and decreased hypoglycemia by 30–60%. Hybrid and model predictive control algorithms demonstrated comparable efficacy, while adaptive systems allowed personalized basal insulin adjustment. Adverse events were minor and…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 124 participants or records.
Read the paper
Related studies
- Safety and efficacy of COVID‐19 vaccines: A systematic review and meta‐analysis of controlled and randomized clinical trials
- Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies
- Determinants of passive antibody efficacy in SARS-CoV-2 infection: a systematic review and meta-analysis
- Cleaning efficacy of EDDY versus ultrasonically-activated irrigation in root canals: a systematic review and meta-analysis
- Bonding Efficacy of Universal Resin Adhesives to Zirconia Substrates: Systematic Review and Meta-Analysis
- In vitro antimicrobial activity of extracts and essential oils of Cinnamomum, Salvia, and Mentha spp. against foodborne pathogens: A meta-analysis study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.