Luo, Yingying and Chang, Yaping and Zhao, Zhan and Xia, Jun and Xu, Chenchen and Bee, Yong Mong and Li, Xiaoying and Sheu, Wayne H. -H. and McGill, Margaret and Chan, Siew Pheng and Deodat, Marisa and Suastika, Ketut and Thy, Khue Nguyen and Chen, Liming and Kong, Alice Pik Shan and Chen, Wei and Deerochanawong, Chaicharn and Yabe, Daisuke and Zhao, Weigang and Lim, Soo and Yao, Xiaomei and Ji, Linong (2023) Device-supported automated basal insulin titration in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Lancet Regional Health-Western Pacific, 35. ISSN 2666-6065, DOI https://doi.org/10.1016/j.lanwpc.2023.100746.
Full text not available from this repository.Abstract
Background Technological advances make it possible to use device-supported, automated algorithms to aid basal insulin (BI) dosing titration in patients with type 2 diabetes. Methods A systematic review and meta-analysis of randomized controlled trials were performed to evaluate the efficacy, safety, and quality of life of automated BI titration versus conventional care. The literature in Medline, Embase, Web of Science, and the Cochrane databases from January 2000 to February 2022 were searched to identify relevant studies. Risk ratios (RRs), mean differences (MDs), and their 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Findings Six of the 7 eligible studies (889 patients) were included in meta-analyses. Low- to moderate-quality evidence suggests that patients who use automated BI titration versus conventional care may have a higher probability of reaching a target of HbA1c <7.0% (RR, 1.82 95% CI, 1.16-2.86]); and a lower level of HbA1c (MD, -0.25% 95% CI, -0.43 to -0.06%]). No statistically significant differences were detected between the two groups in fasting glucose results, incidences of hypoglycemia, severe or nocturnal hypoglycemia, and quality of life, with low to very low certainty for all the evidence. Interpretation Automated BI titration is associated with small benefits in reducing HbA1c without increasing the risk of hypoglycemia. Future studies should explore patient attitudes and the cost-effectiveness of this approach.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Type 2 diabetes; Basal insulin; Automated titration; Glucose control; HbA1c level; Hypoglycemia; Systematic review |
| Subjects: | G Geography. Anthropology. Recreation > GE Environmental Sciences R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 30 Oct 2025 08:18 |
| Last Modified: | 30 Oct 2025 08:18 |
| URI: | http://eprints.um.edu.my/id/eprint/48712 |
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