Eliminating mealtime insulin boluses while maintaining glycemic safety remains a key challenge in automated insulin delivery (AID) for T1DM. This randomized crossover study, published in Diabetes Care, evaluated the safety and feasibility of the Automated Insulin Delivery as an Adaptive NETwork (AIDANET) system used without meal announcements.

Adults, young adults, and adolescents with T1DM were enrolled across three U.S. centers. Participants used FCL and UC in a randomized sequence. Each study period included supervised use followed by at-home use. The prespecified primary outcome was the change in mean sensor glucose during the at-home FCL period compared with UC.

A total of 34 participants completed the study. Mean sensor glucose improved from 178 mg/dL during UC to 164 mg/dL during FCL (P = 0.0058). Time in range (70-180 mg/dL) and time in tight range (70-140 mg/dL) increased significantly. Time above range (>180 mg/dL and >250 mg/dL) declined. These improvements occurred predominantly overnight.

Time spent below 70 mg/dL and 54 mg/dL met predefined noninferiority criteria during FCL, indicating no increase in hypoglycemia risk compared with UC.

These findings show that FCL therapy with AIDANET improves average glycemic control without meal bolusing, supporting simplified diabetes management across a broad age range of people with T1DM.