Abstract Aims To provide an updated analysis of the performance of different hybrid closed loop (HCL) systems in randomised controlled trials (RCTs) on subjects with type 1 diabetes. Materials and methods We conducted a systematic review with meta‐analysis. We searched four online databases and performed hand‐searching of conference proceedings to find studies from inception to 18 April 2025. We included RCTs enrolling subjects with type 1 diabetes, evaluating commercial HCL systems against other insulin therapy regimens, with a duration of intervention ≥2 weeks, and reporting time in range (TIR) as an outcome. Studies involving pregnant women were excluded. Results A total of 37 studies evaluating seven different HCL systems (CamAPS Fx, Control IQ, DBLG1, iLet BP, MiniMed 670G, MiniMed 780G, and Omnipod 5) were included. In studies with a mean age < 18 years, mean TIR was 64.1% (95% CI: 61‐67.2), ranging from 59.3% (95% CI: 49.6‐69.1) with MiniMed 780G to 68% (95% CI: 65.8‐70.3) with Control IQ, and end‐of‐study HbA1c was 7.4% (95% CI: 7‐7.7), ranging from 6.7% (95% CI: 6.6‐6.9) with CamAPS Fx to 7.9% (95% CI: 6.9‐9) with MiniMed 780G. In studies with a mean age ≥ 18 years, mean TIR was 70.8% (95% CI: 68.6‐73), ranging from 63.1% (95% CI: 59.4‐66.8) with Omnipod 5 to 74.4% (95% CI: 69.7‐79.1) with MiniMed 780G, and end‐of‐study HbA1c was 7.1% (95% CI: 7‐7.3), ranging from 7.0% (95% CI: 6.9‐7.1) with Control IQ to 7.2% (95% CI: 7‐7.5) with MiniMed 670G. Conclusions In RCTs, commercial HCL systems show different achievements of CGM metrics and HbA1c in people with type 1 diabetes.
Molfetta et al. (2025) studied this question.