Two Years On: What a Large French Study Found About Automated Insulin Delivery in Real Life

Automated insulin delivery (AID) systems have shown promise in clinical trials, but how do they perform when thousands of people use them in everyday life? A large French study set out to answer that question by tracking 2,225 people with Type 1 diabetes who started using AID systems between 2023 and 2024. The researchers followed these users for two years, measuring whether the technology's benefits held steady over time.

One of the key measures researchers tracked was time in range—the percentage of time a person's blood sugar stays between 70 and 180 mg/dL, which is considered the target zone. At one year, median time in range was 70%. At two years, it remained at 70%, showing that the improvement was sustained rather than fading over time.

When researchers compared two-year results to the very beginning—before people started using AID—the improvements were clear. Time in range increased by 12 percentage points overall. Average HbA1c (a three-month blood sugar average) dropped from 7.6% to 7.1%, a meaningful improvement that reflects better long-term control.

A critical question for any new treatment is whether people actually keep using it. In this study, 81.1% of the original 2,741 participants had available data at the two-year mark. Of those, only 2.1% had discontinued their AID system by two years. This high continuation rate suggests that users found the technology valuable enough to stick with it long-term.

The study also examined safety, specifically severe hypoglycemic episodes (dangerously low blood sugar requiring help from another person). Compared to baseline, fewer participants experienced at least one severe hypoglycemic episode in the 12 months before the two-year follow-up than in the 12 months before starting AID. This reduction is important, as severe lows are a key concern for people managing Type 1 diabetes.

The study revealed an important pattern: people whose blood sugar was higher at baseline (HbA1c of 8% or above) saw greater improvements in time in range over the two-year period than those who started with better control. This suggests AID systems may have the largest impact for people who were struggling most with blood sugar management before adopting the technology.

Source: Diabetes technology & therapeutics. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.