A recent trial has demonstrated that the use of automated insulin delivery (AID) systems significantly improves blood sugar control for adults with type 2 diabetes. The study, spanning 13 weeks, revealed notable reductions in HbA1c levels and an increase in the time patients spent within the target glucose range.
The trial involved 319 adults using insulin to manage their type 2 diabetes, with half utilizing an AID system and the other group continuing with their standard insulin treatment. Participants who used the AID system saw an average drop of 0.9 percentage points in HbA1c levels, from 8.2% to 7.3%. In contrast, those in the control group experienced a more modest reduction of 0.3 percentage points, from 8.1% to 7.7%. The difference was statistically significant, with AID users achieving a 0.6 percentage point improvement over controls.
In addition to improving HbA1c levels, AID users spent significantly more time in the target glucose range of 70-180 mg/dL. Their time in range increased from 48% to 64%, while the control group saw a minimal change, from 51% to 52%. This equated to an additional 3.4 hours per day spent in the desired glucose range.
The AID system used in the trial was the Tandem t:slim X2 insulin pump, paired with a Dexcom G6 continuous glucose monitor (CGM). The system’s Control-IQ+ technology, which automatically adjusts insulin delivery based on real-time glucose readings, was shown to offer substantial benefits for individuals with type 2 diabetes—particularly those using adjunct treatments such as GLP-1 receptor agonists or SGLT2 inhibitors.
Roy Beck, MD, PhD, of the Jaeb Center for Health Research and lead investigator of the 2IQP trial, emphasized that this study represents one of the most rigorous examinations of AID technology in type 2 diabetes patients. While AID systems have proven effective for type 1 diabetes, fewer studies have explored their application in type 2 diabetes, making these findings particularly valuable.
Notably, the study highlighted that patients on GLP-1 drugs like Ozempic, or on a combination of GLP-1 and SGLT2 inhibitors, showed even greater improvements in their HbA1c levels when paired with the AID system.
The trial, which took place across 21 centers in the U.S. and Canada, involved participants aged 19-87, who had been living with type 2 diabetes for an average of 18 years. At baseline, the average HbA1c was 8.1%, and most participants were using either insulin pumps or multiple daily insulin injections.
In terms of insulin use, those in the AID group saw a reduction in their total daily insulin dose, dropping from 95 units per day to 87 units by the end of the trial. By comparison, the control group’s insulin usage remained largely unchanged, with a slight increase from 102 units to 104 units per day.
However, there were some minor side effects associated with AID use, including modest weight gain and an increase in adverse events. The AID group experienced 106 adverse events compared to 26 in the control group, though most were unrelated to the system itself. One death occurred in the control group, attributed to pancreatitis and multiorgan failure.
Despite these challenges, the study’s authors noted that the incidence of hypoglycemia remained low throughout the trial, consistent with previous research in type 2 diabetes patients.
While these results are promising, the authors acknowledge that the study’s scope is limited to adults with insulin-treated type 2 diabetes and lacks data on the time required for AID device training. Nonetheless, the trial adds to the growing body of evidence supporting the use of automated insulin delivery systems as a promising tool for improving diabetes management.
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