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Meta-Analysis
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Oct 15, 2025; 16(10): 111230
Published online Oct 15, 2025. doi: 10.4239/wjd.v16.i10.111230
Role of automated insulin delivery in managing insulin-treated outpatients with type 2 diabetes: A systematic review and meta-analysis
Abul Bashar Mohammad Kamrul-Hasan, Joseph M Pappachan, Lakshmi Nagendra, Nazma Akter, Sweekruti Jena, Deep Dutta, Sunil Nair
Abul Bashar Mohammad Kamrul-Hasan, Department of Endocrinology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, Greater Manchester, United Kingdom
Joseph M Pappachan, Sunil Nair, Department of Endocrinology, Countess of Chester Hospital NHS Foundation Trust, Chester CH2 1UL, Cheshire, United Kingdom
Joseph M Pappachan, Department of Endocrinology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Lakshmi Nagendra, Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, Karnataka, India
Nazma Akter, Department of Endocrinology, MARKS Medical College and Hospital, Dhaka 1206, Bangladesh
Sweekruti Jena, Department of Endocrinology, Kalinga Hospital, Bhubaneshwar 751023, Odisha, India
Deep Dutta, Department of Endocrinology, CEDAR Superspeciality Healthcare, New Delhi 110075, Delhi, India
Sunil Nair, Faculty of Health, Medicine and Society, Chester Medical School, Chester CH1 4BJ, Cheshire, United Kingdom
Author contributions: Kamrul-Hasan ABM and Pappachan JM were responsible for the integrity of the work as a whole; Kamrul-Hasan ABM, Pappachan JM, and Nagendra L collected and analyzed the data and drew the tables and figures; Kamrul-Hasan ABM, Pappachan JM, and Nair S wrote the draft; Kamrul-Hasan ABM and Dutta D conceptualized and designed the study; Nagendra L, Akter N, Jena S, and Dutta D reviewed and revised the manuscript; Nagendra L, Akter N, Jena S, and Nair S performed the full-text review and data identification; Nagendra L, Akter N, and Dutta D evaluated the quality of the literature; Pappachan JM and Nair S adjudicated any disagreements; Each author made contributions to the article and endorsed the submitted version.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joseph M Pappachan, MD, MRCP, FRCP, Professor, Senior Researcher, Faculty of Science, Manchester Metropolitan University, Lower Ormond Street, Manchester M15 6BH, Greater Manchester, United Kingdom. drpappachan@yahoo.co.in
Received: June 26, 2025
Revised: August 14, 2025
Accepted: September 15, 2025
Published online: October 15, 2025
Processing time: 112 Days and 0 Hours
Core Tip

Core Tip: This is the first systematic review and meta-analysis specifically targeting the efficacy and safety of automated insulin delivery (AID) systems in patients with type 2 diabetes in the outpatient setting. Analyzing six randomized controlled trials and nine single-arm studies involving 28985 participants, we observed that AID systems enhance glycemic control, evidenced by larger decreases in glycated hemoglobin and improved continuous glucose monitoring metrics compared to standard treatment. AID use increases time in range, reduces time above target glucose, and maintains similar rates of hypoglycemia and serious adverse events. While AID slightly increases the risk of device deficiency, safety is still within acceptable limits. The results indicate short-term effectiveness, but larger and longer-term studies are necessary to confirm the benefits and assess cost-effectiveness.