In January 2022, the Scottish Health Technology Group, SHTG, released a recommendation of the closed-loop systems and the artificial pancreas for type one diabetes mellitus (T1DM). A network meta-analysis and three pairwise meta-analyses found statistically significant improvements in mean percentage time in range for people with type one diabetes using a closed-loop system compared with other insulin-based therapies. The pairwise meta-analyses also reported statistically significant reductions in mean percentage time spent in hyperglycemia and hypoglycemia. High heterogeneity was present in all meta-analyses for all outcomes. The limited use of closed-loop systems in routine clinical care makes it difficult to estimate device-related adverse event rates.
The SHTG recommended that single hormone closed-loop systems should be available to people with type one diabetes (pediatric and adult) who:
- Under their current diabetes care plan, continue to have suboptimal glycemic control, a high risk of severe hypoglycemia, or impaired awareness of hypoglycemia, or
- Experience diabetes-related distress, measured using a validated tool, that adversely affects the quality of life or their ability to manage diabetes, and which is likely to be improved by moving to a closed-loop system.
No evidence was identified for artificial pancreas systems (multi-hormone closed-loop systems) available on the UK market.
Read more in English here.
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