A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes

Yogish C Kudva1, Dan Raghinaru, John W Lum

  • 1Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN (Y.C.K., D.D., C.K.); Jaeb Center for Health Research, Tampa, FL (D.R., J.W.L., T.C., C.S., L.K., C.K., R.W.B.); Diabetes and Endocrine Treatment Specialists, Sandy, UT (T.E.G., A.N.T., R.D.L.); Rocky Mountain Clinical Research, Idaho Falls, ID (D.L.); Division of Endocrinology, Diabetes, and Nutrition, Baltimore VA Medical Center, Baltimore, MD (E.K.S., L.G.S., J.C.); Division of Endocrinology, Emory University School of Medicine, Emory University, Atlanta, GA (F.J.P., G.M.D., F.Z.T.); Harold Schnitzer Diabetes Health Center, Oregon Health and Science University, Portland, OR (A.A., C.S., A.D.); Mary and Dick Allen Diabetes Center, Hoag Memorial Hospital Presbyterian, Newport Beach, CA (D.T.A., B.D.); Division of Endocrinology, Metabolism, and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (G.A., J.K., K.C., E.F.); Texas Diabetes and Endocrinology, Austin, TX (T.B., L.C., V.E., J.P.); Division of Endocrinology, Henry Ford Health System, Detroit, MI (D.K., J.K.J., K.E., S.M.); Division of Endocrinology, Center for Diabetes Technology, University of Virginia, Charlottesville, VA (S.A.B., S.A., J.D.); Division of Endocrinology, Icahn School of Medicine at Mount Sinai, New York (C.J.L., C.L., G.O., A.I.); and Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, SUNY Upstate Medical University, Syracuse (R.S.W., S.B.), NY; Boston Medical Center, Boston, MA (D.W.S., A.A.C.); Division of Endocrinology, St Joseph's Health Care, Lawson Health Research Institute, London, Ontario, Canada (T.S., S.L.L., M.D.); University of Washington School of Medicine, Seattle (I.B.H., X.A.); and Rainier Clinical Research Center, Renton (F.B., S.M.), WA; Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (M.R.R., A.J.P., C.V.D.-B.); Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada (M.A.T., M.-R.P., V.T., A.M.); UT Southwestern Medical Center, University of Texas, Southwestern, Dallas, TX (P.R., L.F.J.); University Hospitals Cleveland Medical Center, Cleveland, OH (B.H., A.L.); and Tandem Diabetes Care, San Diego, CA (J.E.P., R.S.-K.).

PubMed
Summary

Automated insulin delivery (AID) systems show promise for managing type 2 diabetes, especially for individuals not reaching glycemic targets with other medications. Further research is needed to confirm its benefits in this population.

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
644
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.8K
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
835
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.2K
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
597
Carbohydrate Metabolism01:36

Carbohydrate Metabolism

Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
13.7K