Could AID Transform Type 2 Diabetes Care?
Key takeaways:
- AID systems can increase time in range, lower A1C, and reduce hypoglycemia in people with type 2 diabetes.
- Use of the technology is safe and effective, research shows, even among older adults and those receiving home care.
- People with type 2 diabetes and caregivers have expressed confidence and satisfaction with AID systems in studies.
Automated insulin delivery (AID) systems, which began as an innovative treatment option for people with type 1 diabetes, are now available to help those with type 2 diabetes on insulin more easily manage their blood sugar levels.
This diabetes technology pairs continuous glucose monitoring (CGM) with an insulin pump, allowing the AID system to automatically reduce insulin delivery when blood sugar is predicted to fall and increase delivery when blood glucose is predicted to rise.
Advanced AID systems, including the Omnipod 5, Tandem's Control-IQ+, and the Medtronic MiniMed 780G, are now available for adults 18 and over with type 2 diabetes.
AID improves time in range
Research shows that AID leads to many of the same benefits in type 2 diabetes as in type 1 diabetes: Improved time in range, reduced hypoglycemia, and better A1C. Importantly, these benefits were consistent across different study settings regardless of which AID system was used.
A study of Tandem Control-IQ+ users with type 2 diabetes found that time in range increased by about 15% (from 56% to 71%) at six weeks. This translates to an increase of 3.6 hours per day spent in range.
Dr. Anders Carlson, diabetes medical director at the International Diabetes Center in Minnesota, said this finding is in line with studies in type 1 diabetes as well as the time in target range guidelines for type 1 diabetes.
More recently, a 2025 study found that participants with type 2 using Tandem's AID system saw their A1C fall from 8.2% to 7.3%. In another study using the Medtronic MiniMed 780G, people with type 2 diabetes were able to achieve 71-75% time in range outside of a clinical trial, again meeting the targets for diabetes.
“This is really compelling evidence that in a real-world setting, this AID system can work for people with type 2 diabetes,” said Dr. Gregory Forlenza, associate professor of pediatric endocrinology at the University of Colorado.
Participants who used the recommended MiniMed 780G settings (i.e. the lowest glucose target) achieved a time in range of 80%.
For Carlson, this finding raises an important question: What are the optimal settings for AID in type 2 diabetes? For instance, since low blood sugar (hypoglycemia) is less of a concern, it may be beneficial to have more aggressive targets from the get-go.
Another study investigated the Omnipod 5 AID system in participants with type 2 diabetes, finding strong improvements in time in range with minimal hypoglycemia. Among those on multiple daily injections (MDI), time in range increased from 43% to 58% at six months. Participants on basal insulin only saw even larger improvements in time in range, from 31% to 65% at six months.
Dr. Anne Peters, professor of clinical medicine at the Keck School of Medicine of the University of Southern California, also highlighted reductions in total daily insulin dose among participants on MDI – yet another way in which AID could simplify type 2 diabetes management.
How could combining AID with diabetes medication affect glucose levels?
Growing use of GLP-1 receptor agonists, SGLT2 inhibitors, and diabetes technology poses new questions for the future of diabetes care. That is, how might the combination of technology and medications optimize outcomes for people with type 2 diabetes?
In the Omnipod 5 study, half of the participants were also taking a GLP-1 or SGLT2. Overall, AID users also taking medication saw greater improvements in time in range (28%) compared to those who were only taking insulin.
Carlson said this finding suggests that combining GLP-1s or SGLT2s with AID could potentially lead to even better glycemic control than AID alone – though formal studies will be needed to test this hypothesis.
Forlenza noted the ability of GLP-1s to reduce insulin needs. Combining these powerful medications with AID may help people with type 2 diabetes improve blood sugar management and lose weight. It’s possible these improvements could even help people work toward diabetes remission.
What about AID for older adults with type 2 diabetes?
Starting insulin can be challenging for people of all ages, but it can be especially complex for older adults or disabled people with type 2 diabetes who receive home care.
Elderly people have a higher risk of severe hypoglycemia and diabetic ketoacidosis. Diabetes management for older adults can also be complicated by impaired cognition or dementia, reduced mobility, and difficulty accessing care.
In this context, the CLOSE AP+ study investigated AID assisted by nurses for people with type 2 diabetes unable to manage MDI at home. The study tested Control-IQ technology in 25 participants who had an average age of 70 years.
At 12 weeks, time in range improved significantly, from 37% to 63%. Time below range was less than 1%, while time above range was under 10%. The majority of participants reached the American Diabetes Association guidelines for older people with diabetes, which recommend:
- At least 50% time in range (70-180 mg/dL)
- Less than 1% time below range (<70 mg/dL)
- Less than 10% time above range (>250 mg/dL)
It’s also worth noting that participants using Control-IQ technology saw a 1.3% reduction in A1C. Over 90% of participants reached an A1C of less than 8% by the end of the trial, without any increase in severe hypoglycemia. This study helps confirm that the benefits of AID extend beyond the “standard” person with type 2 diabetes to older adults and people with disabilities.
The bottom line
Numerous studies demonstrate that AID is safe and effective for people with type 2 diabetes. Both clinical trials and real-world data show that this technology increases time in range and improves A1C while minimizing hypoglycemia.
“I want to emphasize that across a wide variety of real-world and clinical trial evidence sets, and across very different AID systems, everyone is either doing a great job hitting a goal for time in range or achieving a massive improvement in glucose control,” Forlenza said. He noted that AID systems lead to time in range increases of 15% to 24% in people with type 2 diabetes – nearly double the improvements typically seen in type 1 diabetes.
Beyond glycemic data, it’s also important to consider user experience with AID. Overall, the data suggests that people with type 2 diabetes had good satisfaction and confidence in using these systems. Even people who hadn’t previously used diabetes devices reported a positive experience with AID, Peters said.
“I honestly wasn’t sure my patients would like AID – many were technology-naive people,” Peters said. “But they loved it and they wanted to stay on it because they felt it improved their glycemic control.”
Learn more about technology to help manage type 2 diabetes here: