Dados do Trabalho

Título

Automated Insulin Delivery Systems and Sleep Quality in Type 1 Diabetes: A Systematic Review and Meta-Analysis

Introdução

INTRODUCTION: Recent progress in automated insulin delivery (AID) systems for type 1 diabetes (T1D) has significantly enhanced glycemic control and minimized the risk of hypoglycemia. Despite these improvements, research on the effects of AID systems on sleep quality in T1D patients remains limited. This meta-analysis aims to address this gap by investigating how AID systems affect sleep outcomes and overall well-being in these patients, providing a comprehensive assessment of their influence on sleep quality.

Objetivo

OBJECTIVE: To evaluate the impact of automated insulin delivery systems on sleep quality in individuals with type 1 diabetes.

Métodos

METHODS: This research was performed according to the PRISMA guideline. PubMed, Scopus, and Cochrane Central databases were searched to identify randomized trials comparing AID systems to other therapeutic approaches in patients with type 1 diabetes. For continuous outcomes, we calculated mean differences (MD) with 95% confidence intervals (CI). These were analyzed using a random-effects model. Statistical analyses were performed using R statistical software version 4.4.0 and p < 0,05 were considered statistically significant.

Resultados

RESULTS: A total of 3 studies and 280 patients were included. Among them, 199 were allocated to the AID group and 141 were allocated to the control group. The number of female and male patients was similar, with 149 (53.02%) women and 132 (46.97%) men. Regarding sleep quality, no difference was found between the automated insulin delivery system and the control group, as assessed by the Pittsburgh Sleep Quality Index PSQI (MD -0.6814; 95% CI -1.9405, 0.5776; P = 0.289). Similarly, there was no notable improvement in the Diabetes Treatment Satisfaction Questionnaire status (MD 0.9; 95% CI -1.0712, 2.8712; P = 0.371). Additionally, no statistically significant differences were observed in Hypoglycemia Fear Survey (HFS-II) Behavior (MD -3.8259; 95% CI -12.3968, 4.7450; P = 0.382) and HFS-II Worry (MD -3.1272; 95% CI -10.6672, 4.4129; P = 0.416).

Conclusões

CONCLUSION: This meta-analysis indicates that, although the automated insulin delivery system may provide benefits in other areas, it does not show a significant advantage over the control group in terms of sleep quality, diabetes treatment satisfaction or hypoglycemia-related fear in T1D patients. Further studies with proper designs are needed to clarify and confirm these associations.

Palavras -chave

KEY WORDS: Automated Insulin Delivery Systems; Type 1 Diabetes; Meta-Analysis