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Courtney A. South (1), Meryem K. Talbo (1), Tricia M. Peters (2,3), Daiva Nielsen (1), Anne-Sophie Brazeau (1,4)

1: School of Human Nutrition, McGill University, Montreal, QC. 2: Lady Davis Institute of Medical Research, Jewish General Hospital, Montreal, QC. 3: The Jewish General Hospital, Division of Endocrinology, Department of Medicine, McGill University, Montreal, QC. 4: Research Center of the Quebec Heart and Lung Institute, QC, Canada.

Automated Insulin Delivery (AID) systems reduce the management burden and improve glycemic control for people with type 1 diabetes (PwT1D) by automatically providing insulin as a response to continuously measured glucose levels. There is a lack of evidence on AID and nutrition outcomes.

To analyze the literature regarding AID use and nutrition outcomes in PwT1D and synthesize current evidence regarding AID’s relationship with nutrition.

Two researchers conducted a blinded search of Medline (OVID) and PubMed for studies including AID use (compared to multiple daily injections or pumps) and nutrition-related variables. Studies from 2000 to 2022 were included, as were PwT1D of all ages.

A total of 2,188 articles were screened for appropriateness. After exclusions, n=7 studies were included (2017-2022): 4 qualitative, 1 two-arm crossover, 1 observational, retrospective, and 1 theoretical review. In quantitative studies, AID was associated with lower eating distress (p=0.004), but not carbohydrate (grams) intake in meals (p=0.24) and snacks (p=0.99). In qualitative studies, AID seemed to increase the frequency and portions of food intake and led to less dietary control from parents. PwT1D using AID reported eating foods higher in fat, carbohydrate, and energy density. PwT1D were less worried about achieving accurate carbohydrate counting. It was reported that PwT1D believed AID use would lead to decreased skills in carbohydrate counting.

AID appeared to influence eating behaviours, dietary patterns, and carbohydrate counting although evidence to support this relationship was limited. AID may reduce food management burden due to the perception that AID can correct for carbohydrate counting inaccuracy.

There is a need to determine if AID allows for simplification of carbohydrate counting and improves eating behaviours while maintaining glycemic stability. Further research will allow health care professionals such as Registered Dietitians to reform nutritional recommendations for those who use AID.

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