Resumen de Investigación
Analyzed using Evidence Intelligence™

Automated insulin delivery improves glucose management in diabetes with CKD

Última actualización 23 de agosto de 2026

Key finding

Time in range improved from 60% at the end of usual care to 73% at the end of AID (p < 0.001).

This study compared automated insulin delivery (AID) with usual care in individuals with diabetes and advanced chronic kidney disease, finding significant improvements in glucose control.

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 compared automated insulin delivery (AID) with usual care in individuals with diabetes and advanced chronic kidney disease, finding significant improvements in glucose control.

Clinical relevance

Improving glucose control is crucial for individuals with diabetes and chronic kidney disease, as it can reduce the risk of complications. The significant increase in time spent in the target glucose range with AID suggests that this technology may offer a valuable alternative to traditional management methods.

Keep in mind

The study's sample size may limit generalizability. Participants were only from one clinical setting. The long-term effects of AID were not assessed.

Published in

Referencia de la Revista

Publication details and source links for this paper.

Jean CL, Christine LM, Bella H, et al. Automated insulin delivery compared with usual care in people with diabetes and advanced chronic kidney disease: a randomized crossover trial. Diabetologia. 2026;69(8):2168-2181. doi:10.1007/s00125-026-06732-3

Efectos Principales

AID improved percentage time in range from 60% to 73% (p < 0.001).

Hypoglycemia rates were unchanged during the study.

25% of participants experienced hospital admissions unrelated to device use.

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 Hospitalization rate, Hypoglycemia symptom score, Time in range.

Primary intervention

Continuous glucose monitoring

Primary outcomes

  • Hospitalization rate
  • Hypoglycemia symptom score
  • Time in range

Evidence relationships

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

6
Evidence pairs
6
Relationships
3
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

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: 72

3

Related topics

6

Evidence pairs

682

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 6 evidence relationships
  • Includes primary outcome data
  • Linked to 3 direct semantic evidence topics

Topic contributions

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 CGM Time in Range

Evidencia relacionada

Tema de evidencia

Diabetes Technology

Guardar evidencia

Tema de evidencia

Hypoglycemia

Guardar evidencia

Core evidence

Study findings

The primary outcomes reported in this study.

Hospitalization rate

Continuous glucose monitoring → Hospitalization rate

Continuous glucose monitoring → Hospitalization rate

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Hypoglycemia symptom score

Continuous glucose monitoring → Hypoglycemia symptom score

Continuous glucose monitoring → Hypoglycemia symptom score

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Time in range

Continuous glucose monitoring → Time in range

Continuous glucose monitoring → Time in range

Evidence Intelligence™
EvidenceScore™
86
Strong
ImpactScore™
81
Positive
ConsistencyScore™
75
consistent
Estudios de apoyo: Basado en 8 estudios
Add to Evidence Tracker

Hospitalization rate

Hybrid closed-loop system → Hospitalization rate

Hybrid closed-loop system → Hospitalization rate

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Hypoglycemia symptom score

Hybrid closed-loop system → Hypoglycemia symptom score

Hybrid closed-loop system → Hypoglycemia symptom score

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
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™
79
Positive
ConsistencyScore™
69
generally_consistent
Estudios de apoyo: Basado en 17 estudios
Add to Evidence Tracker

Evidence Library

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evidence suggest

La Evidencia Sugiere

  • AID increased time in target glucose range by 13.7% (p < 0.001).
  • Hypoglycemia rates showed no change.
  • 25% of participants had unrelated hospital admissions.
who this applies

A quién se aplica

  • Adults with diabetes and advanced chronic kidney disease.
  • Individuals requiring insulin therapy.
keep in mind

Tener en Cuenta

  • Results may not apply to younger populations or those without kidney disease.
  • The study did not evaluate long-term outcomes of AID.
  • Further research is needed to confirm findings in diverse populations.
between the lines

Entre Líneas

  • The study's sample size may limit generalizability.
  • Participants were only from one clinical setting.
  • The long-term effects of AID were not assessed.

Evidence Library

Build your 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 improve cgm time in range?

Strong Evidence

Insulin Delivery Systems may improve CGM Time in Range.

ConsistencyScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

  1. 1

    Time in range

    EvidenceScore™ Strong | EvidenceScore™ 87.9 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study

Why this answer: This answer is cautious because the available studies report mixed findings.

Limitations

  • Population details are unavailable.
27 supporting studiesUpdated: Aug 2026

Does Continuous glucose monitoring improve hospitalization rate?

Emerging Evidence

Current evidence does not show a clear benefit of Continuous glucose monitoring for Hospitalization rate.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Hospitalization rate

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Aug 2026

Does Continuous glucose monitoring affect hypoglycemia symptom score?

Emerging Evidence

Current evidence does not show a clear benefit of Continuous glucose monitoring for Hypoglycemia symptom score.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Hypoglycemia symptom score

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Aug 2026

Does Hybrid closed-loop system improve hospitalization rate?

Emerging Evidence

Current evidence does not show a clear benefit of Hybrid closed-loop system for Hospitalization rate.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Hospitalization rate

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
  • Consistency cannot yet be determined.
  • Population details are unavailable.
1 supporting studyUpdated: Aug 2026
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