Objective: To assess the benefit of automated insulin delivery (AID) across a wide range of participant characteristics and evaluate whether there are any characteristics that can predict whether a patient is not likely to be a successful AID user. Methods: A secondary analysis was conducted using data from the 2IQP randomized controlled trial that assessed AID using the t:slim X2 insulin pump with Control-IQ+ technology compared with a control group that continued their prestudy insulin delivery method and used continuous glucose monitoring over 13 weeks in 319 adults with insulin-treated type 2 diabetes. The analyses evaluated participant characteristics associated with baseline HbA1c, glycemic outcomes according to participant characteristics, and characteristics of participants who discontinued AID prior to 13 weeks. Results: Glycemic improvement with AID was observed across a wide range of participant characteristics, including age, sex, race/ethnicity, education level, and baseline HbA1c, and was not dependent on prior insulin pump experience or knowledge of carbohydrate counting. Participants with the highest baseline HbA1c (≥9.0%) had the greatest improvement in HbA1c with AID compared with the control group (−2.3% ± 1.2% vs. −1.0% ± 1.1%). Nineteen (8.8%) participants in the AID group either dropped from the study or discontinued the AID system prior to 13 weeks. There was no clear pattern of characteristics that differentiated those who discontinued AID prior to 13 weeks and those who had AID active ≥90% of the time. Conclusions: The glycemic benefit of AID was observed across a wide range of participant characteristics. Furthermore, there were no identifiable characteristics that were associated with unsuccessful use of AID or a lack of beneficial glycemic response with AID. Therefore, AID should be a consideration for all adults with insulin-treated type 2 diabetes.
Singh et al. (2026) studied this question.