Body weight trends in individuals with type 1 diabetes using automated insulin delivery vs. traditional insulin pumps

Diabetes Metab. 2025 Nov;51(6):101693. doi: 10.1016/j.diabet.2025.101693. Epub 2025 Jul 29.

Abstract

Objective: This study analyzed the determinants of weight gain among participants initiating an automated insulin delivery (AID) system.

Research design and methods: In this observational study, we evaluated 928 persons with type 1 diabetes initiating an insulin pump therapy, including 467 with AID, 98 with pumps with predictive low-glucose suspend (PLGS) algorithm and 363 initiating a sensor-augmented pump (SAP).

Results: After 3 months, median (95CI) TIR increased from 50.69 % [49.2-52.3] to 67.9 % [66.7-69.1] in the AID group and HbA1c levels showed a mean reduction of 0.82 %. AID resulted in equivalent body weight gain to SAP and PLGS despite significant improvements in glucose control. Multivariable analysis revealed that weight gain was linked to baseline HbA1C (P < 0.001) and age but not to the type of pump system. During follow-up, percentage increase in body weight at 12 months were similar between groups CONCLUSIONS: In persons with T1D, AID did not increase weight gain in comparison to other pump systems.

Keywords: Automated insulin delivery; Closed-loop system; Diabetes; Real-world evidence, Weight.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Blood Glucose
  • Body Weight*
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / drug therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents* / administration & dosage
  • Insulin Infusion Systems* / adverse effects
  • Insulin* / administration & dosage
  • Male
  • Middle Aged
  • Weight Gain* / drug effects
  • Young Adult

Substances

  • Insulin
  • Hypoglycemic Agents
  • Glycated Hemoglobin
  • Blood Glucose