Last updated August 22, 2026
Key finding
Participants reported a reduction in diabetes burden and distress.
Use of a fully closed-loop insulin delivery system in adults with type 1 diabetes.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Short-Term (≤3 mo)
Risk of bias
Some Concerns
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Plain-language summary
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Study focus
Use of a fully closed-loop insulin delivery system in adults with type 1 diabetes.
This study evaluated Use of a fully closed-loop insulin delivery system in adults with type 1 diabetes.
Limitations were not clearly described in the extracted text.
Published in
Publication details and source links for this paper.
Rama L, Sara H, Julia W, et al. Closing the Loop in Adults With Type 1 Diabetes (CLEAR) randomized crossover study. Diabetes Technology & Therapeutics. 2024;26(4):211-221. doi:10.1089/dia.2023.0394
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Hybrid closed-loop system, Insulin therapy and Diabetes distress scores, Hypoglycaemia confidence measured by the Hypoglycemia Confidence Scale, Quality of life, and 1 more.
This study contributes evidence to
Primary intervention
Hybrid closed-loop system
Primary outcomes
Evidence topics
Primary intervention
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.
2
Related topics
7
Evidence pairs
210
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence relationship
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Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Hybrid closed-loop system → Diabetes distress scores
Hybrid closed-loop system → Diabetes distress scores
Hybrid closed-loop system → Hypoglycaemia confidence measured by the Hypoglycemia Confidence Scale
Hybrid closed-loop system → Hypoglycaemia confidence measured by the Hypoglycemia Confidence Scale
Hybrid closed-loop system → Quality of life
Hybrid closed-loop system → Quality of life
Hybrid closed-loop system → Treatment satisfaction
Hybrid closed-loop system → Treatment satisfaction
Insulin therapy → Diabetes distress scores
Insulin therapy → Diabetes distress scores
Insulin therapy → Hypoglycaemia confidence measured by the Hypoglycemia Confidence Scale
Insulin therapy → Hypoglycaemia confidence measured by the Hypoglycemia Confidence Scale
Insulin therapy → Treatment satisfaction
Insulin therapy → Treatment satisfaction
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Insulin Delivery Systems and Diabetes distress scores, Insulin Delivery Systems and Quality of Life Outcomes.
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 measuring Diabetes distress scores
Measures Diabetes distress scores as a key outcome.
All studies on Insulin Delivery Systems
Contributes to Insulin Delivery Systems evidence base.
All studies measuring Quality of Life Outcomes
Measures Quality of Life Outcomes as a key outcome.
Latest published studies
Published within the last 2 years.
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4 results
3 results
4 results
4 results
3 results
Generated from the study's connected evidence using Evidence Intelligence™.
Insulin Delivery Systems may improve Quality of Life Outcomes.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Quality of life
EvidenceScore™ Strong | EvidenceScore™ 79.0 | weak positive | ConsistencyScore™ Generally Consistent | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Insulin Therapies may improve Treatment Experience.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
Treatment satisfaction
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is based on 3 supporting studies with generally consistent results and a positive effect signal.
Limitations
Insulin Delivery Systems appears to improve Treatment Experience.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Treatment satisfaction
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a small number of supporting studies and should be interpreted cautiously.
Limitations
Hybrid closed-loop system appears to improve Diabetes distress scores.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Diabetes distress scores
EvidenceScore™ Strong | EvidenceScore™ 79.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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