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Updated: Aug 13, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Contemporary automated insulin delivery systems in older adults with type 1 diabetes: A systematic review and
Piyush Ratan1, Marconi Abreu2, Luisa Saldarriaga3
1Patna Medical College and Hospital, Patna, Bihar, India.
Abstract:
Older adults with type 1 diabetes are clinically heterogeneous, with variable cognition, dexterity, comorbidity burden, caregiver support, and prior technology experience. Evidence on automated insulin delivery (AID) systems in this population remains limited and largely observational. We performed a systematic review and meta-analysis of contemporary AID systems in adults aged ≥60 years with type 1 diabetes. We searched PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov through February 2026. Nine studies (7 observational studies and 2 randomized crossover trials; 8,765 participants) were included. We pooled outcomes during AID use using single-arm random-effects meta-analyses. When baseline data were available, we performed change-from-baseline analyses. Pooled mean time in range (TIR) was 77.95% (95% CI 75.31-80.59), HbA1c was 6.95% (52 mmol/mol) (95% CI 6.67-7.24), and time below range (TBR) < 70 mg/dL was 1.35% (95% CI 1.12-1.57). From baseline, AID use was associated with higher TIR, lower hyperglycemia, lower HbA1c (MD - 0.36%; 95% CI - 0.63 to - 0.09), and lower diabetes distress, without increased hypoglycemia. Findings were consistent in direction with broader AID literature. Older age alone should not preclude individualized AID use.
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