{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:23Z","timestamp":1792384883328,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To compare insulin delivery modalities for glycaemic control, body weight and insulin dose in adults with insulin\u2010treated Type 2 diabetes.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n We searched eight databases and two trial registries until 27 April 2026 for parallel\u2010group randomised trials comparing pre\u2010specified insulin delivery modalities. The primary network meta\u2010analysis excluded the clinically heterogeneous residual Other node. Outcomes were changes in\n HbA1c<\/jats:styled-content>\n , time in range (\n TIR<\/jats:styled-content>\n ), time above range (\n TAR<\/jats:styled-content>\n ), time below range (\n TBR<\/jats:styled-content>\n ), body weight and insulin dose; certainty was assessed with\n CINeMA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Thirty\u2010seven reports describing 36 independent trials with 4157 participants were included. Median follow\u2010up was 12\u2009weeks. In the primary no\u2010Other analysis, hybrid closed\u2010loop (\n HCL<\/jats:styled-content>\n ) reduced\n HbA1c<\/jats:styled-content>\n versus multiple daily injections (\n MDI<\/jats:styled-content>\n ;\n MD<\/jats:styled-content>\n \u22120.79%, 95%\n CI<\/jats:styled-content>\n \u22121.33 to \u22120.25), increased\n TIR<\/jats:styled-content>\n (\n MD<\/jats:styled-content>\n +16.00 percentage points, 95%\n CI<\/jats:styled-content>\n +8.77 to +23.22), reduced\n TAR<\/jats:styled-content>\n (\n MD<\/jats:styled-content>\n \u221213.48 percentage points, 95%\n CI<\/jats:styled-content>\n \u221223.05 to \u22123.91) and reduced insulin dose (\n MD<\/jats:styled-content>\n \u221215.69\u2009U\/day, 95%\n CI<\/jats:styled-content>\n \u221231.33 to \u22120.06). Continuous subcutaneous insulin infusion also reduced\n HbA1c<\/jats:styled-content>\n (\n MD<\/jats:styled-content>\n \u22120.47%, 95%\n CI<\/jats:styled-content>\n \u22120.74 to \u22120.20) and insulin dose. Fully closed\u2010loop yielded larger\n TIR<\/jats:styled-content>\n \/\n TAR<\/jats:styled-content>\n estimates, but from one short trial only and should be considered hypothesis\u2010generating.\n HCL<\/jats:styled-content>\n increased body weight (\n MD<\/jats:styled-content>\n +1.58\u2009kg, 95%\n CI<\/jats:styled-content>\n +0.75 to +2.40). Most trials had risk\u2010of\u2010bias concerns and low\u2010risk sensitivity analysis was infeasible.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HCL<\/jats:styled-content>\n showed the most consistent glycaemic benefit, but body\u2010weight and sparse safety evidence warrant caution.\n FCL<\/jats:styled-content>\n findings require larger, longer confirmation.\n <\/jats:p>\n \n Trial Registration: PROSPERO registration:<\/jats:bold>\n CRD420261381231.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.71104","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:09:06Z","timestamp":1783998546000},"page":"9767-9778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Efficacy of Insulin Delivery Modalities on Glycaemic Control in Adults With Type 2 Diabetes: A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4557-1777","authenticated-orcid":false,"given":"Ruining","family":"Yang","sequence":"first","affiliation":[{"name":"Faculty of Medicine Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyi","family":"Lu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixian","family":"Liang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runzhi","family":"Liu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxin","family":"Rui","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixun","family":"Xu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Anning First People's Hospital Affiliated to Kunming University of Science and Technology Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(25)00299\u20102"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26\u2010S009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc26\u2010S007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)61037\u20100"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16\u20102201"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010022\u201002144\u2010z"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2415948"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci19\u20100028"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102022\u2010074068"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103190"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739\u2010016\u20101583\u20107"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14\u20102385"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003082"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1045"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010015\u20100060\u20108"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cl2.1080"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24\u20100623"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc\u20102021\u2010002590"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13030642"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac034"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15059"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968211050649"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0513"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2024.2422005"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(18)30025\u20101"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0299"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.14979"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22\u20100034"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.3.626"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1026485130100"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u20105\u201057"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71104","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.71104","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:20:15Z","timestamp":1792383615000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.71104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/dom.71104"],"URL":"https:\/\/doi.org\/10.1111\/dom.71104","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.71104\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v1\/review5","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.71104\/v2\/review1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"assertion":[{"value":"2026-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}