Many adults with type 1 diabetes (T1D) continue to rely on multiple daily insulin injections despite suboptimal glycemic outcomes. Data presented at the European Society of Cardiology Congress 2025 evaluated an automated insulin delivery (AID) system compared with multiple daily injections plus continuous glucose monitoring (CGM).

The study enrolled seventy-nine adults aged 18–70 years with type 1 diabetes for at least one year and HbA1c of 7.5-11%.  All participants used multiple daily insulin injections along with continuous glucose monitoring for 14 days before being assigned to study groups. Participants were assigned 2:1 to automated insulin delivery with continuous glucose monitoring or to continue multiple daily injections with continuous glucose monitoring for 13 weeks.

At 13 weeks, AID significantly improved HbA1c with an adjusted mean difference of -0.8% (-9 mmol/mol) compared with control (p<0.0001). Time in range (70–180 mg/dL) increased by 23.4% (p<0.0001). Hypoglycemia remained low, with median time <54 mg/dL at 0.18% for AID versus 0.08% for control. No episodes of severe hypoglycemia or diabetic ketoacidosis were reported. Total daily insulin dose and body mass index remained similar between groups.

These findings show that direct transition from multiple daily injections to automated insulin delivery is both safe and effective, offering meaningful improvements in glycemic control for adults with T1D who are not meeting targets.