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A literature search was performed using MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials (RCTs) on long-term use (not less than 8 weeks) of CLS in patients with T1DM were selected. Meta-analysis was performed with RevMan V.5.3.5 to compare CLS with controls (continuous subcutaneous insulin infusion with blinded continuous glucose monitoring or unblinded sensor-augmented pump therapy or multiple daily injections or predictive low-glucose suspend system) in adults and children with type 1 diabetes. Research quality evaluation was conducted using the Cochrane risk of bias tool. Eleven RCTs (817 patients) that satisfied the eligibility criteria were included in the meta-analysis. Compared with controls, the CLS group had a favorable effect on the proportion of time with sensor glucose level in 3.9\u201310\u2009mmol\/L (10.32%, 8.70% to 11.95%), above 10\u2009mmol\/L (\u22128.89%, \u221210.57% to \u22127.22%), or below 3.9\u2009mmol\/L (\u22121.09%, \u22121.54% to \u22120.64%) over 24 hours. The CLS group also had lower glycated hemoglobin levels (\u22120.30%, \u22120.41% to \u22120.19%), and glucose variability, coefficient of variation of glucose, and SD were lower by 1.41 (\u22122.38 to \u22120.44, p=0.004) and 6.37\u2009mg\/dL (\u22129.19 mg\/dL to \u22123.55\u2009mg\/dL, p&lt;0.00001). There were no significant differences between the CLS and the control group in terms of daily insulin dose, quality of life assessment, and satisfaction with diabetes treatment. CLS is a better solution than control treatment in optimizing blood glucose management in patients with T1DM. CLS could become a common means of treating T1DM in clinical practice.<\/jats:p>","DOI":"10.1136\/bmjdrc-2021-002633","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:22:48Z","timestamp":1653304968000},"page":"e002633","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["Better TIR, HbA1c, and less hypoglycemia in closed-loop insulin system in patients with type 1 diabetes: a meta-analysis"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2316-3692","authenticated-orcid":false,"given":"Xiaojuan","family":"Jiao","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifa","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"2025073112083521000_10.2.e002633.1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldr020"},{"key":"2025073112083521000_10.2.e002633.2","unstructured":"International Diabetes Federation . 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