Evidence map›Paper›PMID 36069869›Full record

Trial reportThe New England journal of medicine2022

Open-Source Automated Insulin Delivery in Type 1 Diabetes.

Mercedes J Burnside, Dana M Lewis, Hamish R Crocket, Renee A Meier, Jonathan A Williman, Olivia J Sanders, Craig A Jefferies, Ann M Faherty, Ryan G Paul, Claire S Lever and 7 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 5 pooled it
21.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 5 syntheses or guidelines pooled it, 161 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Real-World Evidence of Automated Insulin Delivery System Use.Diabetes technology & therapeutics · 2024
    Pooled it
  5. Guideline
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Article
  11. The Architect of Trust: Dr Tom Ferguson's Legacy.Journal of participatory medicine · 2026
    Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. [Effect of glycemic variability on the efficacy of artificial pancreas systems: A real-world study].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026
    Article
  17. Review
  18. Article
  19. Article
  20. Review

17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 5 institutions in 2 countries.

Mercedes J BurnsideFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Dana M LewisFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Hamish R CrocketFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Renee A MeierFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Jonathan A WillimanFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Olivia J SandersFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Craig A JefferiesFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Ann M FahertyFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Ryan G PaulFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Claire S LeverFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Sarah K J PriceFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Carla M FrewenFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Shirley D JonesFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Tim C GunnFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Christina LampeyFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Benjamin J WheelerFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
Martin I de BockFrom the Departments of Pediatrics (M.J.B., R.A.M., O.J.S., M.I.B.) and Population Health (J.A.W.), University of Otago, and the Department of Pediatrics, Canterbury District Health Board (M.J.B., O.J.S., M.I.B.), Christchurch, Te Huataki Waiora School of Health, Sport and Human Performance, University of Waikato (H.R.C.), and Waikato Regional Diabetes Service, Waikato District Health Board (R.G.P., C.S.L., S.K.J.P.), Hamilton, the Department of Pediatric Endocrinology, Starship Children's Health, Auckland District Health Board (C.A.J., A.M.F., C.L.), and the Liggins Institute, University of Auckland (C.A.J.), Auckland, the Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago (C.M.F., S.D.J., B.J.W.), and the Pediatric Department, Southern District Health Board (B.J.W.), Dunedin, and Nightscout New Zealand, Hamilton (T.C.G.) - all in New Zealand; and OpenAPS, Seattle (D.M.L.).
University of Otago · NZOpen Society · CZSouthern District Health Board · NZUniversity of Auckland · NZUniversity of Waikato · NZ

Funding

Health Research Council of New Zealand 19/481
6 · The paper itself

Abstract

backgroundOpen-source automated insulin delivery (AID) systems are used by many patients with type 1 diabetes. Data are needed on the efficacy and safety of an open-source AID system.

methodsIn this multicenter, open-label, randomized, controlled trial, we assigned patients with type 1 diabetes in a 1:1 ratio to use an open-source AID system or a sensor-augmented insulin pump (control). The patients included both children (defined as 7 to 15 years of age) and adults (defined as 16 to 70 years of age). The AID system was a modified version of AndroidAPS 2.8 (with a standard OpenAPS 0.7.0 algorithm) paired with a preproduction DANA-i insulin pump and Dexcom G6 CGM, which has an Android smartphone application as the user interface. The primary outcome was the percentage of time in the target glucose range of 70 to 180 mg per deciliter (3.9 to 10.0 mmol per liter) between days 155 and 168 (the final 2 weeks of the trial).

resultsA total of 97 patients (48 children and 49 adults) underwent randomization (44 to open-source AID and 53 to the control group). At 24 weeks, the mean (±SD) time in the target range increased from 61.2±12.3% to 71.2±12.1% in the AID group and decreased from 57.7±14.3% to 54.5±16.0% in the control group (adjusted difference, 14 percentage points; 95% confidence interval, 9.2 to 18.8; P<0.001), with no treatment effect according to age (P = 0.56). Patients in the AID group spent 3 hours 21 minutes more in the target range per day than those in the control group. No severe hypoglycemia or diabetic ketoacidosis occurred in either group. Two patients in the AID group withdrew from the trial owing to connectivity issues.

conclusionsIn children and adults with type 1 diabetes, the use of an open-source AID system resulted in a significantly higher percentage of time in the target glucose range than the use of a sensor-augmented insulin pump at 24 weeks. (Supported by the Health Research Council of New Zealand; Australian New Zealand Clinical Trials Registry number, ACTRN12620000034932.).

Indexed as

Blood GlucoseDiabetes Mellitus, Type 1Hypoglycemic AgentsInfusion PumpsInsulinAdolescentAdultAgedAustraliaChildHumansMiddle AgedYoung AdultBlood GlucoseHypoglycemic AgentsInsulin

Identifiers

PMID36069869
OpenAlexW4294908094

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.