- Design
- Single-arm, multicentre pivotal trial, 13 weeks
- Population
- 307 adults with insulin-treated type 2 diabetes, aged 19–85
- Primary outcome
- HbA1c change from baseline to 13 weeks
- Effect
- 8.1% to 7.4%, −0.7 points (95% CI −0.9 to −0.6); time in range +16 points
A single-arm pivotal study in Diabetes Care (7 October) enrolled 307 adults aged 19 to 85 with insulin-treated type 2 diabetes. After a baseline sensor period, each person switched to an automated insulin delivery (AID) system for 13 weeks. HbA1c fell from 8.1% to 7.4%, and time in range rose from 57% to 73%.
The largest falls were in people starting at 9% or above, and the effect held in those who stayed on a GLP-1 receptor agonist or SGLT2 inhibitor. Hypoglycaemia was low at baseline and stayed low. One participant developed diabetic ketoacidosis; there was no severe hypoglycaemia.
AID is now standard in type 1 diabetes, and this adds to a growing set of type 2 studies. But there was no control arm, so some of the fall reflects closer contact and regression from a high baseline. For now, AID in type 2 diabetes is worth considering for people on multiple daily injections who remain well above target despite adherence, with pump training and ketone advice built in.
- Consider AID for insulin-treated type 2 patients whose HbA1c stays above 9% on injections
- Continue a GLP-1 receptor agonist or SGLT2 inhibitor alongside the pump; the study kept both
- Teach ketone testing and pump-failure rules before starting, including in type 2 diabetes
- Review sensor data at four to six weeks rather than waiting for the next HbA1c
Why it matters
Pump-based closed loops are no longer only a type 1 conversation.
Don't overread it
Single-arm and 13 weeks long — without a control group, the size of the benefit is uncertain.
The statistics, in plain English
The HbA1c fall of 0.7 points has a 95% confidence interval of 0.6 to 0.9, so the change from baseline is precise. What it cannot show is how much of that change a control group given the same attention would also have achieved.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for diabetes & endocrinology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free