Evidence Intelligence™
- EvidenceScore™
- 85
- Strong
- ImpactScore™
- 81
- Positive
- ConsistencyScore™
- 85
- consistent
Supporting studies: Based on 13 studies
Add to Evidence TrackerResearch Summary
Analyzed using Evidence Intelligence™
AHCL Improves Glycemic Control in Adults with Type 1 Diabetes
Last updated September 10, 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
Journal Reference
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
Main Effects
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
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Evidence Context
This study contributes evidence to Continuous glucose monitoring, Hybrid closed-loop system and HbA1c, Time in range.
This study contributes evidence to
Primary intervention
Continuous glucose monitoring
Primary outcomes
- HbA1c
- Time in range
Primary intervention
Primary outcomes
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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Primary evidence
Evidence relationship
Insulin Delivery Systems and HbA1c
Related evidence
Evidence relationship
Insulin Delivery Systems and CGM Time in Range
Save evidence
Evidence topic
Diabetes Technology
Save evidence
Core evidence
Study findings
The primary outcomes reported in this study.
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
Supporting studies: Based on 16 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- 86
- Strong
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 8 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- 88
- Strong
- ImpactScore™
- 81
- Positive
- ConsistencyScore™
- 71
- generally_consistent
Supporting studies: Based on 21 studies
Add to Evidence TrackerEvidence Library
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Evidence Suggest
- 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 to
- Adults with Type 1 diabetes.
- Individuals using or considering advanced diabetes management technologies.
Keep in Mind
- 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
- 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.
Related evidence relationships
Explore in Evidence ExplorerThis study contributes to the evidence on the following intervention-outcome relationships.
Devices & Technology
Insulin Delivery Systems → CGM Time in Range
Devices & Technology
Evidence Intelligence™
- EvidenceScore™
- 88
- Strong
- ImpactScore™
- 81
- Positive
- ConsistencyScore™
- 71
- generally_consistent
Supporting studies: Based on 21 studies
View evidenceDevices & Technology
Insulin Delivery Systems → CGM Time in Range
Devices & Technology
Evidence Intelligence™
- EvidenceScore™
- 88
- Strong
- ImpactScore™
- 75
- Positive
- ConsistencyScore™
- 56
- generally_consistent
Supporting studies: Based on 16 studies
View evidenceIncluded in these evidence collections
Curated evidence collections and hubs this study is part of.
Explore more in Evidence Explorer
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All studies on Hybrid closed-loop system and Time in range
Intervention: Hybrid closed-loop systemOutcome: Time in range
21 results
All studies on Continuous glucose monitoring and Time in range
Intervention: Continuous glucose monitoringOutcome: Time in range
16 results
All studies on Hybrid closed-loop system
Intervention: Hybrid closed-loop system
21 results
All studies on Continuous glucose monitoring
Intervention: Continuous glucose monitoring
16 results
All studies measuring Time in range
Outcome: Time in range
21 results
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
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.
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
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.
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