Introduction and Objective: Automated insulin delivery (AID) systems have transformed glucose management in type 1 diabetes, but their role in type 2 diabetes mellitus (T2DM) remains less clearly defined. The present study determines the efficacy and safety of AID systems in elderly populations with T2DM. Methods: This study is a systematic review and meta-analysis of randomized controlled trials. Elderly population with T2DM using AID systems were included. Conventional insulin therapy was used as a comparator. Safety and glycemic outcomes were considered primarily time in range, time above range along with secondary outcomes of change in HbA1c, standard deviation of glucose, coefficient of variability and rate of adverse events. Mean differences and odds ratios were used to estimate pooled effect. Results: 12 studies met the inclusion criteria, encompassing various closed loop systems, including CamAPS HX, DBLG1 and d-Nav Insulin device. The study demonstrated mixed findings in glycemic control improvement, with a significant increase in Time in rangeMD=19.92(95% CI=14,40,25.44) while decrease in HbA1c and Mean glucose levels, without increasing hypoglycemia or insulin requirements. Conclusion: AID has been proven to be a safe and effective alternative to conventional insulin therapy for glycemic management in T2DM yet further research is needed to assess long-term outcomes, cost-effectiveness, and implementation in broader clinical settings. Disclosure Z.V. Patel: None. P. Patel: None. D.H. Desai: None. K. Patel: None. V. Patel: None. Y. Patel: None. D. Patel: None. Z. Patel: None.
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