Introduction & Objective: Diabetes distress (DD) is prevalent among people with diabetes (PwD). While automated insulin delivery systems (AID) improve glycemic control and are expected to alleviate diabetes burden, their impact on DD is unclear.
Methods: Adhering to PRISMA guidelines, we focused on PwD using AID versus other insulin delivery systems, with DD as the outcome. Our review included randomized controlled trials (RCTs), before-after studies (BAS), and observational studies. We employed a random effects model meta-analysis by population (adult/pediatric/caregiver) and study design.
Results: Of 828 articles initially, 27 were included in the systematic review, comprising 3297 participants (1884 adults, 787 children, 626 caregivers). Seventeen studies were selected for the meta-analysis. In adults, six BAS and three RCTs indicated a significant DD reduction post-AID initiation (standardized mean difference (95% confidence intervals) -0.32 (95% CI: -0.39, -0.25) and (-0.18 (-0.30, -0.05)). No significant changes in DD were observed in the pediatric population or caregivers post-AID initiation, though three RCTs in caregivers nearly reached significance (-0.28 (-0.62, 0.05)).
Conclusion: This work suggests that AID does improve DD in adults but not in younger PwD. More RCTs and systematic DD assessments are now needed, especially in the pediatric population.
D. Canha: None. V.K. McMahon: None. S. Schmitz: None. F. Alzaid: None. Y.V. Reznik: Board Member; Insulet Corporation, TIMKL, France, embecta. Consultant; Vitalaire, France. Speaker's Bureau; Eli Lilly and Company. J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. G. Fagherazzi: Speaker's Bureau; Sanofi. Advisory Panel; Timkl, SAB Biotherapeutics, Inc., Vitalaire, Roche Diabetes Care. G.A. Aguayo: None.
