Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 50
- Neutral
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerResearch Summary
Analyzed using Evidence Intelligence™
Meal anticipation does not improve glycemic control in T1D
Last updated August 24, 2026
Key finding
TBR was reduced in FCL+ (median 0% [0-0%] vs. 0% [0-0.8%]; P = 0.03).
This study evaluated the glycemic impact of meal anticipation in automated insulin delivery systems for adults with Type 1 Diabetes, finding no significant differences in time in range between systems.
Quick read
Study at a glance
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
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the glycemic impact of meal anticipation in automated insulin delivery systems for adults with Type 1 Diabetes, finding no significant differences in time in range between systems.
Clinical relevance
Understanding the effectiveness of meal anticipation in insulin delivery systems is crucial for optimizing diabetes management. This study's findings suggest that while automated systems are beneficial, simply adding meal anticipation may not enhance glycemic control, guiding future research and clinical practices.
Keep in mind
The study's sample size and demographic characteristics may limit generalizability. Potential confounding factors were not fully controlled. Results may not apply to younger populations or those with different diabetes management strategies.
Published in
Journal Reference
Publication details and source links for this paper.
Jose G, Patricio C, Orianne V, et al. Glycemic Impact of Meal Anticipation in Automated Insulin Delivery Systems in Adults with Type 1 Diabetes. Diabetes Care. 2023;46(9):1652-1658. doi:10.2337/dc23-0119
Main Effects
No significant difference in TIR after breakfast between FCL+ and FCL (P = 0.62).
TBR after dinner was reduced in FCL+ compared to FCL (P = 0.03).
Overall 24-h control was highest in HCL (86 ± 10%) compared to FCL and FCL+ (77 ± 11% and 77 ± 12%, respectively).
Evidence network
How this study fits
Understand where this research contributes within the broader evidence network.
Evidence Context
This study contributes evidence to Full Closed Loop (FCL), Full Closed Loop with Meal Anticipation (FCL+), Hybrid closed-loop system and Time in range, Time below range.
This study contributes evidence to
Primary intervention
Full Closed Loop (FCL)
Primary outcomes
- Time in range
- Time below range
Evidence topics
Primary intervention
Primary outcomes
Evidence relationships
Intervention and outcome relationships this study adds to the evidence network.
4
Evidence pairs
4
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: 68
3
Related topics
4
Evidence pairs
636
Related studies
High relevance in at least one topic
Why it is useful
- Contributes to 4 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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Primary evidence
Evidence relationship
Insulin Delivery Systems and CGM Time in Range
Related evidence
Evidence topic
Diabetes Technology
Save evidence
Evidence topic
Hypoglycemia
Save evidence
Core evidence
Study findings
The primary outcomes reported in this study.
Time below range
Full Closed Loop with Meal Anticipation (FCL+) → Time below range
Full Closed Loop with Meal Anticipation (FCL+) → Time below range
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 25
- Negative
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerTime in range
Full Closed Loop with Meal Anticipation (FCL+) → Time in range
Full Closed Loop with Meal Anticipation (FCL+) → Time in range
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 50
- Neutral
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- 88
- Strong
- ImpactScore™
- 79
- Positive
- ConsistencyScore™
- 69
- generally_consistent
Supporting studies: Based on 17 studies
Add to Evidence TrackerEvidence Library
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Evidence Suggest
- FCL+ showed a significant reduction in TBR after dinner (P = 0.03).
- Overall 24-h control was better in HCL compared to FCL and FCL+.
- No significant differences in TIR after breakfast between FCL+ and FCL.
Who this applies to
- Adults with Type 1 Diabetes.
- Individuals using automated insulin delivery systems.
Keep in Mind
- The findings may not be applicable to populations outside the study's demographic.
- The effectiveness of meal anticipation in other contexts remains uncertain.
- Further research is needed to explore long-term impacts of these systems.
Between the Lines
- The study's sample size and demographic characteristics may limit generalizability.
- Potential confounding factors were not fully controlled.
- Results may not apply to younger populations or those with different diabetes management strategies.
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.
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™
- 79
- Positive
- ConsistencyScore™
- 69
- generally_consistent
Supporting studies: Based on 17 studies
View evidenceDevices & Technology
Insulin Delivery Systems → CGM Time in Range
Devices & Technology
Evidence Intelligence™
- EvidenceScore™
- Moderate
- Score 69 · Based on 2 studies
- ImpactScore™
- 75
- Positive
- ConsistencyScore™
- 35
- mixed
Supporting studies: Based on 2 studies
View evidenceIncluded in these evidence collections
Curated evidence collections and hubs this study is part of.
Explore more in Evidence Explorer
Jump to pre-filtered views in Evidence Explorer.
All studies on Hybrid closed-loop system and Time in range
Intervention: Hybrid closed-loop systemOutcome: Time in range
17 results
All studies on Hybrid closed-loop system and Time below range
Intervention: Hybrid closed-loop systemOutcome: Time below range
2 results
All studies on Hybrid closed-loop system
Intervention: Hybrid closed-loop system
17 results
All studies measuring Time in range
Outcome: Time in range
17 results
All studies measuring Time below range
Outcome: Time below range
2 results
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
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.
Does Full Closed Loop (FCL) improve time in range?
Emerging Evidence
Current evidence does not show a clear benefit of Full Closed Loop (FCL) for Time in range.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Time in range
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.
Does Full Closed Loop with Meal Anticipation (FCL+) improve time in range?
Emerging Evidence
Current evidence does not show a clear benefit of Full Closed Loop with Meal Anticipation (FCL+) for Time in range.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Time in range
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.
Does Full Closed Loop with Meal Anticipation (FCL+) improve time below range?
Emerging Evidence
Full Closed Loop with Meal Anticipation (FCL+) may worsen Time below range or be associated with harm.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Time below range
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | moderate negative | 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.
Next steps
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