Last updated July 12, 2026
Key finding
HbA1c decreased from 8.6% to 8.1% (p = 0.0002)
This study evaluated a decision support system for insulin dosing in adults with type 1 diabetes, finding a significant reduction in HbA1c levels.
Quick read
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
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated a decision support system for insulin dosing in adults with type 1 diabetes, finding a significant reduction in HbA1c levels.
Improving glycemic control in adults with type 1 diabetes is crucial to reduce long-term complications. The significant reduction in HbA1c levels with the decision support system suggests that such technology can enhance diabetes management, potentially leading to better health outcomes for patients.
Limited sample size may affect generalizability Short duration of follow-up may not capture long-term effects Potential for unmeasured confounders affecting outcomes
Published in
Publication details and source links for this paper.
Alessandra K, Anas EF, Natasha G, et al. A decision support system for insulin dosing in adults with type 1 diabetes: a randomized controlled trial. Nature Communications. 2025;16:8593. doi:10.1038/s41467-025-63671-0
HbA1c decreased from 8.6% to 8.1% in the DSS group (p = 0.0002)
HbA1c decreased from 8.6% to 8.5% in the control group (p = 0.22)
No severe hypoglycemia events were reported in either group
No diabetic ketoacidosis events were reported in either group
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Decision Support System (DSS), Non-adaptive bolus calculator (control) and Diabetic ketoacidosis, HbA1c, Hypoglycemia events.
This study contributes evidence to
Primary intervention
Decision Support System (DSS)
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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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.
1
Related topics
6
Evidence pairs
205
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Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Core evidence
The primary outcomes reported in this study.
Decision Support System (DSS) → Diabetic ketoacidosis
Decision Support System (DSS) → Diabetic ketoacidosis
Decision Support System (DSS) → Hypoglycemia events
Decision Support System (DSS) → Hypoglycemia events
Non-adaptive bolus calculator (control) → Diabetic ketoacidosis
Non-adaptive bolus calculator (control) → Diabetic ketoacidosis
Non-adaptive bolus calculator (control) → Hypoglycemia events
Non-adaptive bolus calculator (control) → Hypoglycemia events
Evidence Library
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Decision Support System (DSS) and Diabetic ketoacidosis, Decision Support System (DSS) and HbA1c.
This study contributes to the evidence on the following intervention-outcome relationships.
Devices & Technology
Devices & Technology
Curated evidence collections and hubs this study is part of.
All studies on Decision Support System (DSS)
Contributes to Decision Support System (DSS) evidence base.
All studies measuring Diabetic ketoacidosis
Measures Diabetic ketoacidosis as a key outcome.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
Latest published studies
Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Decision Support System (DSS) appears to improve HbA1c.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Decision Support System (DSS) for Diabetic ketoacidosis.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Diabetic ketoacidosis
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Decision Support System (DSS) for Hypoglycemia events.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Hypoglycemia events
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Non-adaptive bolus calculator (control) for Diabetic ketoacidosis.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Diabetic ketoacidosis
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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