AID beneficial and safe option for improving HbA1C among insulin-dependent type 2 diabetes patients: JAMA
A nonrandomized clinical trial found that HbA1c levels decreased in a diverse group of adults with type 2 diabetes after starting automated insulin delivery (AID). The results suggest that AID could be a beneficial and safe option for insulin-dependent individuals with type 2 diabetes. The study was published in JAMA Network Open by Francisco and fellow researchers.
Type 2 diabetes remains a growing public health challenge, in which many insulin users have difficulty managing their glycemic levels. This study aimed to determine whether AID Would improve glycemic control in adults with type 2 diabetes, a minimum of three months of exogenous insulin before enrollment.
This was a single-arm prospective trial carried out in 21 clinical centers across the United States. The subjects were 305 adults aged 18 to 75 years, who had been on insulin therapy for at least three months; however, patients with previous AID system experience were excluded. The trial commenced with a 14-day standardized therapy period, followed by another time period of 13 weeks active treatment with the Omnipod 5 AID System.
Key Results:
• The primary result was the change in hemoglobin A1c (HbA1c) following 13 weeks of AID use. Researchers also explored the percentage of time within the target glucose range (70-180 mg/dl), hypoglycemia, and additional adverse events.
• Hemoglobin A1c levels were statistically significantly improved; indicated mean reduction from 8.2% (1.3) at baseline to 7.4% (0.9) at 13 weeks (mean difference: −0.8 percentage points; 95% CI, −1.0 to −0.7; p<0.001 for both noninferiority and superiority).
• The average percentage time in the target glucose range (70–180 mg/dL) was significantly improved from 45% (25) at baseline to 66% (17) following use of AID (mean difference: 20 percentage points; 95% CI, 18 to 22; p<0.001).
• Rates of hypoglycemia (glucose less than 54 mg/dL and 70 mg/dL) did not show any differences among groups when comparing AID to standard therapy. Only one episode of severe hypoglycemia was reported, and no cases of diabetic ketoacidosis or HHS.
• Overall consistency across subgroups: AID benefits were consistent with varying age, sex, race and ethnicity, insurance status, or the use of GLP-1RA or SGLT-2i treatments by participants. Improvements were centered on previous insulin regimens.
Researchers provide strong evidence in support of the claim that AID systems can considerably improve glycemic control in adults with insulin-treated type 2 diabetes. The findings continue to express the need for alternative treatment options in order to improve outcomes in type 2 diabetes.
Reference:
Pasquel FJ, Davis GM, Huffman DM, et al. Automated Insulin Delivery in Adults With Type 2 Diabetes: A Nonrandomized Clinical Trial. JAMA Netw Open. 2025;8(2):e2459348. doi:10.1001/jamanetworkopen.2024.59348
