Resumen de Investigación
Analyzed using Evidence Intelligence™

AHCL Improves Glycemic Control in Adults with Type 1 Diabetes

Última actualización 10 de septiembre de 2026

Key finding

Model-based treatment effect of -1.08 percentage points (95% CI = -2.17 to 0.00 percentage points; P = .0508) in favor of AHCL.

This study evaluated the effectiveness of an Advanced Hybrid Closed Loop (AHCL) system compared to Multiple Daily Injections (MDI) plus Real-Time Continuous Glucose Monitoring (RT-CGM) in adults with Type 1 diabetes, finding significant improvements in HbA1c and time in range for the AHCL group.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

This study evaluated the effectiveness of an Advanced Hybrid Closed Loop (AHCL) system compared to Multiple Daily Injections (MDI) plus Real-Time Continuous Glucose Monitoring (RT-CGM) in adults with Type 1 diabetes, finding significant improvements in HbA1c and time in range for the AHCL group.

Clinical relevance

These findings are significant as they suggest that the Advanced Hybrid Closed Loop system could offer better blood sugar management for adults with Type 1 diabetes, potentially reducing the risk of diabetes-related complications. Improved glycemic control can enhance the quality of life and reduce healthcare costs associated with diabetes management.

Keep in mind

The study's sample size and demographic diversity may limit generalizability. The effectiveness of the interventions was not clearly defined in all evidence pairs. Potential confounding factors were not fully addressed.

Published in

Referencia de la Revista

Publication details and source links for this paper.

Tim VDH, Ralf K, Winfried K, et al. Advanced Hybrid Closed Loop in Adult Population With Type 1 Diabetes: A Substudy From the ADAPT Randomized Controlled Trial in Users of Real-Time Continuous Glucose Monitoring. Journal of Diabetes Science and Technology. 2023;18(5):1132-1138. doi:10.1177/19322968231161320

Efectos Principales

The AHCL group demonstrated a mean HbA1c decrease of 1.70 percentage points compared to a 0.60 percentage point decrease in the MDI + RT-CGM group.

The AHCL group spent 73.6% of the time in the target glucose range (70-180 mg/dL), while the MDI + RT-CGM group spent only 46.4%.

The MDI + RT-CGM group showed a mean HbA1c decrease of 0.60 percentage points.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Continuous glucose monitoring, Hybrid closed-loop system and HbA1c, Time in range.

Primary intervention

Continuous glucose monitoring

Primary outcomes

  • HbA1c
  • Time in range

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

4
Evidence pairs
4
Relationships
4
Evidence topics
contributes_evidence

Editorial context

Why this study matters

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Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 68

4

Related topics

4

Evidence pairs

1501

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 4 evidence relationships
  • Includes primary outcome data
  • Linked to 4 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Evidencia principal

Relación de evidencia

Insulin Delivery Systems and HbA1c

Evidencia relacionada

Relación de evidencia

Insulin Delivery Systems and CGM Time in Range

Guardar evidencia

Tema de evidencia

Diabetes Technology

Guardar evidencia

Core evidence

Study findings

The primary outcomes reported in this study.

HbA1c

Continuous glucose monitoring → HbA1c

Continuous glucose monitoring → HbA1c

Evidence Intelligence™
EvidenceScore™
85
Strong
ImpactScore™
81
Positive
ConsistencyScore™
85
consistent
Estudios de apoyo: Basado en 13 estudios
Add to Evidence Tracker

Time in range

Continuous glucose monitoring → Time in range

Continuous glucose monitoring → Time in range

Evidence Intelligence™
EvidenceScore™
88
Strong
ImpactScore™
75
Positive
ConsistencyScore™
56
generally_consistent
Estudios de apoyo: Basado en 16 estudios
Add to Evidence Tracker

HbA1c

Hybrid closed-loop system → HbA1c

Hybrid closed-loop system → HbA1c

Evidence Intelligence™
EvidenceScore™
86
Strong
ImpactScore™
100
Very Positive
ConsistencyScore™
100
consistent
Estudios de apoyo: Basado en 8 estudios
Add to Evidence Tracker

Time in range

Hybrid closed-loop system → Time in range

Hybrid closed-loop system → Time in range

Evidence Intelligence™
EvidenceScore™
88
Strong
ImpactScore™
81
Positive
ConsistencyScore™
71
generally_consistent
Estudios de apoyo: Basado en 21 estudios
Add to Evidence Tracker

Evidence Library

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evidence suggest

La Evidencia Sugiere

  • AHCL reduced HbA1c by 1.70 percentage points, significantly more than MDI + RT-CGM.
  • AHCL users spent 73.6% of time in the target glucose range, compared to 46.4% for MDI + RT-CGM.
  • MDI + RT-CGM showed a lesser HbA1c reduction of 0.60 percentage points.
who this applies

A quién se aplica

  • Adults with Type 1 diabetes.
  • Individuals using or considering advanced diabetes management technologies.
keep in mind

Tener en Cuenta

  • Results may not apply to all populations with Type 1 diabetes.
  • Long-term effects of the AHCL system were not assessed in this study.
  • Further research is needed to confirm these findings across diverse populations.
between the lines

Entre Líneas

  • The study's sample size and demographic diversity may limit generalizability.
  • The effectiveness of the interventions was not clearly defined in all evidence pairs.
  • Potential confounding factors were not fully addressed.

Evidence Library

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Insulin Delivery Systems and CGM Time in Range, Insulin Delivery Systems and CGM Time in Range.

Relaciones de evidencia relacionadas

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Insulin Delivery Systems lower HbA1c?

Strong Evidence

Insulin Delivery Systems appears to lower HbA1c.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    HbA1c

    EvidenceScore™ Strong | EvidenceScore™ 86.2 | strong positive | ConsistencyScore™ Consistent | 1 study

Why this answer: This answer is based on 21 supporting studies with consistent results and a positive effect signal.

21 supporting studies

Does Insulin Delivery Systems improve CGM Time in Range?

Strong Evidence

Insulin Delivery Systems may improve CGM Time in Range.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    Time in range

    EvidenceScore™ Strong | EvidenceScore™ 87.7 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study

Why this answer: This answer is based on 38 supporting studies with generally consistent results and a positive effect signal.

38 supporting studies
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