Summary: In a subgroup analysis of a randomised trial in insulin-treated type 2 diabetes already using a GLP-1 receptor agonist, adding Control-IQ+ automated insulin delivery lowered HbA1c and improved time in range without significant weight gain, compared with continuing usual insulin delivery plus CGM.
PICO Summary
| Element | Detail |
|---|---|
| Population | 143 GLP-1-receptor-agonist users among 319 adults with insulin-treated type 2 diabetes; prespecified subgroup of a randomised trial, USA. |
| Intervention | Control-IQ+ automated insulin delivery, with the GLP-1 agonist continued. |
| Comparison | Continuation of prior insulin delivery plus continuous glucose monitoring (CGM group), GLP-1 agonist continued. |
| Outcome | Among GLP-1 users, HbA1c fell 0.8% from a baseline of 8.0% with AID, a 0.5% improvement versus the CGM group (95% CI -0.8 to -0.3; p<0.001), with significantly better time in range and hyperglycaemia metrics. There was no significant weight difference in GLP-1 users (0.9 kg; p=0.10), whereas non-users gained 1.9 kg with AID. |
Control-IQ+ AID added to GLP-1 RA therapy
RCT subgroup · type 2 diabetes · 13 weeks
In GLP-1 RA users, adding Control-IQ+ AID cut HbA1c by 0.5% versus CGM plus usual insulin, with better time in range and no significant weight gain.
Expert Commentary
This is a clinically reassuring analysis that answers a question increasingly relevant as GLP-1 receptor agonists become standard, namely whether automated insulin delivery still adds value on top of contemporary, guideline-directed therapy, and the answer here is yes. The HbA1c reduction was both statistically and clinically meaningful, achieved alongside better time in range, and the most useful nuance is the weight finding: AID improved control without the weight gain seen in non-users, plausibly because the GLP-1 agonist offsets insulin’s weight effect, so patients gained glycaemic benefit without the usual trade-off. I would frame it with appropriate care. This is a prespecified subgroup of a larger trial rather than a standalone study, the follow-up was only thirteen weeks, and the comparator was CGM plus usual insulin rather than another automated system, so the result speaks to incremental benefit over non-automated delivery. Can I use this with my patients? Yes, supportively. For insulin-treated type 2 patients already on a GLP-1 agonist who remain above target, this strengthens the case for offering automated insulin delivery as an additive step, with the encouraging expectation of better control and weight neutrality, while longer trials confirm durability.
References
Graham TE, Raghinaru D, Afreen S, et al. Additive benefits of Control-IQ+ AID to GLP-1 receptor agonist use in adults with type 2 diabetes. Diabetes Care. 2025;48(12):2154–2159. doi:10.2337/dc25-1753