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Automated insulin delivery in young children with type 1 diabetes: a systematic review and meta-analysis

Puguh Oktavian1,2, Citrawati Dyah Kencono Wungu3,4, Indah Mohd Amin5

  • 1Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia.

The Journal of Clinical Endocrinology and Metabolism
|March 25, 2026
PubMed

Insights

Automated insulin delivery (AID) systems significantly improve time-in-range for young children with type 1 diabetes. This meta-analysis confirms AID’s benefits and safety in this age group.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Diseases
  • Medical Technology

Background:

  • Automated insulin delivery (AID) systems have not been systematically evaluated in children under 7 years with type 1 diabetes.
  • Type 1 diabetes management in young children presents unique challenges.
  • Evaluating the efficacy and safety of AID in this population is crucial.

Purpose of the Study:

  • To systematically evaluate the glycemic outcomes of AID systems in young children (<7 years) with type 1 diabetes.
  • To conduct a meta-analysis of available studies on AID use in this specific pediatric population.
  • To assess the safety profile of AID systems in children under 7.

Main Methods:

  • Comprehensive literature search across major databases (Web of Science, PubMed, Scopus, CENTRAL) and clinical trial registries.
  • Inclusion of studies reporting glycemic outcomes in children younger than 7 years, excluding non-English publications.
  • Meta-analysis using random-effects models to determine pooled estimates for the primary outcome: change in time-in-range (TIR).

Main Results:

  • The meta-analysis included 30 studies with 1,155 young children, demonstrating a significant increase in TIR (9.88%) with AID systems.
  • AID use resulted in an additional 2.37 hours/day in target glucose range (70-180 mg/dL), with notable improvements overnight.
  • Improvements in TIR were consistent across various AID devices, with reduced hyperglycemia and infrequent severe hypoglycemia or diabetic ketoacidosis.

Conclusions:

  • Automated insulin delivery systems offer significant benefits for improving glycemic control in young children with type 1 diabetes.
  • AID systems demonstrate a favorable safety profile in this pediatric cohort.
  • This systematic review provides evidence supporting the use of AID in managing type 1 diabetes in children under 7 years.
Abstract

Keywords:
automated insulin deliverychildrenclosed-loopdiabetespediatrictype 1

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