Last updated July 12, 2026
Key finding
Patients in the closed-loop group had significantly higher TIR than patients in the control group (76.4 ± 14.1% vs. 61.2 ± 20.0%, p = 0.005).
This study evaluated an open-source hybrid closed-loop automated insulin delivery system in perioperative patients with Type 2 diabetes, finding it significantly improved glucose control compared to conventional insulin pump therapy.
Quick read
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EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Short-Term (≤3 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 an open-source hybrid closed-loop automated insulin delivery system in perioperative patients with Type 2 diabetes, finding it significantly improved glucose control compared to conventional insulin pump therapy.
Effective glucose management is crucial for perioperative patients with Type 2 diabetes, as it can reduce complications and improve recovery outcomes. The findings suggest that the open-source hybrid closed-loop system may offer a more effective approach to insulin delivery in this population, potentially leading to better patient outcomes and reduced healthcare costs.
The study's sample size may limit the generalizability of the findings. The trial was conducted in a specific perioperative setting, which may not reflect broader diabetes management contexts. Long-term effects of the closed-loop system were not assessed.
Published in
Publication details and source links for this paper.
Delin M, Weijie X, Yan Y, et al. Open-Source Hybrid Closed-Loop Automated Insulin Delivery System in Perioperative Patients with Type 2 Diabetes. Biomedicines. 2026;14(5):1098. doi:10.3390/biomedicines14051098
Closed-loop group had significantly higher percentage of time in target glucose range (76.4% vs. 61.2%, p = 0.005).
Mean glucose levels were lower in the closed-loop group (8.1 mmol/L) compared to the control group (9.3 mmol/L, p = 0.009).
The closed-loop group exhibited a 15.6 percentage point reduction in time above range without increasing time below range.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Hybrid closed-loop system, Insulin therapy and Mean glucose from rtCGM, Percentage of time in target glucose range 3.9–10.0 mmol/L, Time above range, and 2 more.
This study contributes evidence to
Primary intervention
Hybrid closed-loop system
Primary outcomes
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.
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Related topics
8
Evidence pairs
710
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Primary evidence
Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Hybrid closed-loop system → Mean glucose from rtCGM
Hybrid closed-loop system → Mean glucose from rtCGM
Hybrid closed-loop system → Percentage of time in target glucose range 3.9–10.0 mmol/L
Hybrid closed-loop system → Percentage of time in target glucose range 3.9–10.0 mmol/L
Hybrid closed-loop system → Time above range
Hybrid closed-loop system → Time above range
Hybrid closed-loop system → Time below range
Hybrid closed-loop system → Time below range
Insulin therapy → Mean glucose from rtCGM
Insulin therapy → Mean glucose from rtCGM
Insulin therapy → Percentage of time in target glucose range 3.9–10.0 mmol/L
Insulin therapy → Percentage of time in target glucose range 3.9–10.0 mmol/L
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Insulin Delivery Systems and CGM Time in Range, Insulin Therapies and CGM Time in Range.
This study contributes to the evidence on the following intervention-outcome relationships.
Devices & Technology
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring CGM Time in Range
Measures CGM Time in Range as a key outcome.
All studies on Insulin Delivery Systems
Contributes to Insulin Delivery Systems evidence base.
All studies on Insulin Therapies
Contributes to Insulin Therapies evidence base.
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Published within the last 2 years.
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17 results
5 results
17 results
5 results
17 results
Generated from the study's connected evidence using Evidence Intelligence™.
Insulin Delivery Systems may improve CGM Time in Range.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Time in range
EvidenceScore™ Strong | EvidenceScore™ 87.9 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study
Time above range
EvidenceScore™ Strong | EvidenceScore™ 78.3 | moderate positive | ConsistencyScore™ Consistent | 1 study
Mean glucose from rtCGM
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Insulin Therapies appears to improve CGM Time in Range.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Time in range
EvidenceScore™ Strong | EvidenceScore™ 81.8 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study
Mean glucose from rtCGM
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | neutral | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is based on 10 supporting studies with consistent results and a positive effect signal.
Limitations
Current evidence does not show a clear benefit of Hybrid closed-loop system for Percentage of time in target glucose range 3.9–10.0 mmol/L.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Percentage of time in target glucose range 3.9–10.0 mmol/L
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 Insulin therapy for Percentage of time in target glucose range 3.9–10.0 mmol/L.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Percentage of time in target glucose range 3.9–10.0 mmol/L
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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