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Automated Insulin Delivery Systems in Cystic Fibrosis-Related Diabetes: A Systematic Review and Meta-Analysis
Bruno L Souza1, Jessica Abramowitz2, Sasan Mirfakhraee2
1Department of Medicine, Federal University of Ceará, Fortaleza, Brazil.
Summary
Automated insulin delivery systems (AIDs) significantly improve glycemic control in people with cystic fibrosis related diabetes (pwCFRD), increasing time in range and reducing hyperglycemia without increasing hypoglycemia. These benefits are sustained long-term.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Pulmonary Medicine
Background:
- Cystic fibrosis-related diabetes (CFRD) presents unique management challenges.
- Automated insulin delivery systems (AIDs) offer a potential solution for optimizing glycemic control in this population.
Purpose of the Study:
- To evaluate the impact of AIDs on glycemic control in people with CFRD (pwCFRD).
- To assess secondary outcomes including metabolic and pulmonary function in pwCFRD using AIDs.
Main Methods:
- A systematic literature search was conducted across major databases (MEDLINE, Embase, Cochrane Library).
- Included studies involved pwCFRD using AIDs with at least 14 days of follow-up and continuous glucose monitoring data.
- Single-arm meta-analyses were performed to analyze outcomes such as time in range (TIR), time above range (TAR), time below range (TBR), average glucose, BMI, and FEV1.
Main Results:
- AIDs significantly increased TIR by 9.55% short-term and 11.55% long-term.
- TAR decreased by 8.41% short-term and 12.96% long-term.
- Average glucose levels decreased, while TBR, BMI, and FEV1 remained unchanged. No increase in hypoglycemia was observed.
Conclusions:
- AIDs effectively improve glycemic control in pwCFRD, demonstrating sustained benefits over 12 weeks.
- The use of AIDs in pwCFRD does not appear to increase hypoglycemia.
- Further large-scale randomized controlled trials are recommended to validate these findings.
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