^{Effects of modern glucose monitoring and insulin delivery technologies on patient-reported outcomes and experiences in individuals with type 1 diabetes: a systematic review and meta-analysis}

<p dir="ltr">BACKGROUND</p><p dir="ltr">Use of technology is central to the management of type 1 diabetes (T1D), while patient-reported outcomes measures (PROMs) can support in the management of these individuals.</p><p dir="ltr">PURPOSE</p><p dir="ltr">To assess the impact of diabetes technologies on PROMs in T1D.</p><p dir="ltr">DATA SOURCES</p><p dir="ltr">Cochrane Library CENTRAL, Embase, MEDLINE®, Scopus and Web of Science were searched for relevant articles from 2013 inception up to August 2025.</p><p dir="ltr">STUDY SELECTION</p><p dir="ltr">We included longitudinal diabetes technology studies assessing validated PROMs in non-pregnant adults with T1D. </p><p dir="ltr">DATA EXTRACTION</p><p dir="ltr">Two reviewers extracted study characteristics and PROMs data independently. Standardized mean differences for PROs were pooled using random-effects meta-analysis.</p><p dir="ltr">DATA SYNTHESIS</p><p dir="ltr">We identified 4,885 articles, comprising 81 independent studies (N=19,148 participants) and 70 different PROMs. Hypoglycemia Fear Survey (HFS) was most commonly used (k=39 studies), followed by Diabetes Treatment Satisfaction Questionnaire (DTSQs/DTSQc) (k=38), Diabetes Distress Scale (DDS) (k=25), and Problem Areas in Diabetes (PAID) scale (k=24). Technology use was associated with lower HFS-Total scores compared with controls (SMD= –0.177; 95%CI [–0.319, –0.036], p=0.014, I²=0.0%), with the largest effect observed in automated insulin device users. A moderate positive effect of diabetes technologies was observed on DTSQs/DTSQc scores (SMD=0.429; 95%CI [0.206, 0.653], p<0.001, I²=72.3%) with a small-to-moderate reduction on DDS/PAID scores (SMD= –0.265; 95%CI[–0.363, –0.166], p<0.001, I²=0.0%). </p><p dir="ltr">LIMITATIONS</p><p dir="ltr">Differences in type of technology, varied use and incomplete reporting of PROMs, and different duration of studies.</p><p dir="ltr">CONCLUSIONS</p><p dir="ltr">Diabetes technologies offer psychological benefits in adults with T1D. The large number of reported PROMs suggest a need to standardize their use.</p><p><br></p>