Variability of insulin requirements in adults with type 2 diabetes during fully closed-loop insulin delivery

The role of automated insulin delivery technology in diabetes

The role of automated insulin delivery systems in diabetes is expanding. Hybrid closed-loop systems are being used in routine clinical practice for treating people with type 1 diabetes. Encouragingly, real-world data reflects the performance and usability observed in clinical trials. We review the commercially available hybrid closed-loop systems, their distinctive features and the associated real-world data. We also consider emerging indications for closed-loop systems, including the treatment of type 2 diabetes where variability of day-to-day insulin requirements is high, and other challenging applications for this technology. We discuss issues around access and implementation of closed-loop technology, and consider the limitations of present closed-loop systems, as well as innovative approaches that are being evaluated to improve their performance.

Automated Insulin Delivery System and People With Type 2 Diabetes: A Topic With Many Facets

Optimizing glucose control is of interest also for patients with type 2 diabetes (T2D). While systems for automated insulin delivery are widely used for patients with type 1 diabetes, as documented by many publications, this is not the case with T2D. Because of the number of such patients, this will change drastically in the next years. Manufacturers can transfer many learnings from type 1 to type 2; however, specific clinical aspects have to be considered. This commentary will discuss these aspects and some of the current activities. Future automated insulin delivery (AID) systems will take data from multisensor systems into account to individualize the AID algorithm, supported by artificial intelligence. There is a high need to document the benefits of AID systems in this patient group.