What question did this study set out to answer?

This trial aimed to evaluate the effectiveness of automated insulin delivery in hospitalized patients with diabetes receiving corticosteroids.

June 7, 2026

1848-P: Automated Insulin Delivery in Hospitalized Individuals with Type 1 or Type 2 Diabetes Receiving Corticosteroids

Key Points

This trial aimed to evaluate the effectiveness of automated insulin delivery in hospitalized patients with diabetes receiving corticosteroids.
Randomized controlled trial of hospitalized adults (N=39) with type 1 or type 2 diabetes on corticosteroids (≥10 mg prednisone) assigned to AID or MDI+CGM.
Both groups utilized real-time continuous glucose monitoring to assess glycemic control.
The primary endpoint was time in range (70-180 mg/dl); key secondary endpoints included mean glucose level and time above/below range.
AID group achieved 69±14% time in range compared to 44±21% in MDI+CGM (adj difference 27%, 95% CI 21 to 34, p<0.001).
Mean glucose was significantly lower with AID (161±21 mg/dL) versus MDI+CGM (199±34 mg/dL, p<0.001).
AID participants spent 14% less time >250 mg/dL (95% CI, -18 to -9%).

Abstract

Introduction and Objective: Steroid-induced hyperglycemia poses a significant management challenge in hospitalized patients with diabetes, with limited data to inform best practices. We compared automated insulin delivery (AID) with multiple daily injections plus continuous glucose monitoring (MDI+CGM) to assess inpatient glycemic outcomes. Methods: In this inpatient randomized controlled trial, adults with type 1 or type 2 diabetes receiving corticosteroids (≥10mg prednisone) were assigned to AID or to continue MDI. Both groups received real-time CGM. The primary endpoint was time in range (70-180 mg/dl). Key secondary endpoints: mean glucose, time above range, and time below 70 mg/dl. Results: Thirty-nine hospitalized participants receiving corticosteroids (prednisone-equivalent dose range: 10-1,250 mg) were assigned to AID (n=19; 62± 13 years; A1c 7.6%) or MDI+CGM (n=20, 60±11 years, A1c 8.1%). The mean percentage of time participants were in the target glucose range of 70 to 180 mg/dL was 69±14% in the AID group vs 44±21% in the control group (adj difference, 27%, 95% CI, 21 to 34, p0.001), Figure. Mean glucose was lower with AID compared to control (161± 21 vs 199 ± 34 mg/dL, p0.001). Patients on AID spent 14% less time 250 (95% CI, -18 to -9%). There was no difference in time below 70 or 54 mg/dL. Conclusion: AID was associated with higher time in range than MDI+CGM in patients with diabetes exposed to corticosteroids in the hospital. Disclosure S. Brown: Research Support; Current; Insulet Corporation, Tandem Diabetes Care, Inc., Dexcom, Inc. Research Support; Ended; Roche Diabetes Care, Tolerion, Inc. R. Lal: Consultant; Current; Abbott Diabetes, Adaptyx Biosciences. Consultant; Ended; Biolinq, Capillary Biomedical, Deep Valley Labs. Consultant; Current; Gluroo, Portal Diabetes, Tidepool. Advisory Panel; Ended; ProventionBio, Lilly, Sanofi, Rezolute. M.S. Hughes: Consultant; Current; Dexcom, Inc., Sanofi, Sequel Med Tech, LLC. T. Akcan: None. M. Basina: None. J. Kirby: Stock/Shareholder; Current; PS Fertility. R. Parab: None. J.M. Feeley: Research Support; Current; Dexcom, Inc. M. Stumpf: None. K. Miller: None. J.C. Costin: None. N. Reyes: None. M.C. Sanchez Valenzuela: None. Z. Wen: None. C. Alix: None. L. Chadalawada: None. M. Weber: None. T. Idrees: Research Support; Current; AbbVie Inc. R.S. Kingman: None. B. Suh: None. M. Morgan: None. Y. Liu: None. M. Lee: None. M. Tan: Advisory Panel; Ended; Vertex Pharmaceuticals Incorporated. Consultant; Current; Novo Nordisk, Amylyx. K. Kingston: None. L. Peng: None. R.W. Beck: Research Support; Current; MannKind Corporation, Abbott Diabetes, Dexcom, Inc., Tandem Diabetes Care, Inc., Sequel Med Tech, DreaMed Diabetes, Ltd. Consultant; Ended; Novo Nordisk, Eli Lilly and Company. Consultant; Current; Zucara Therapeutics. G. Davis: Research Support; Current; Insulet Corporation, Sequel Med Tech. F.J. Pasquel: Research Support; Current; Dexcom, Inc., Insulet Corporation, Ideal Medical Technologies. Research Support; Ended; Novo Nordisk, Tandem Diabetes Care, Inc. Consultant; Ended; Insulet Corporation. Funding The National Institute of Diabetes and Digestive and Kidney Diseases (R01DK138366), with device support from Insulet and Dexcom, Inc.

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