Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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Non-randomized (moderate): Randomization not used or not reported

No control group (high): Single-arm or uncontrolled design

High risk of bias (high): Overall bias rated high

{"intervention_arm_id":"arm_1","reference_arm_ids":[],"comparison_type":"baseline_change"}

lower glycosylated hemoglobin A(HbA) (7.51%7.10%,< 0.001)

HbA1c decreased from 7.51% to 7.10% at second follow-up compared with baseline, suggesting improved average glycemic control in this pre-post analysis.

Systolic blood pressure was lower at second follow-up than at baseline, but the excerpt did not provide the absolute values.

Diastolic blood pressure was lower at second follow-up than at baseline, but the excerpt did not provide the absolute values.

Total cholesterol decreased from baseline to second follow-up, indicating a favorable lipid change, though the absolute size was not available in the excerpt.

lower low-density lipoprotein (LDL) cholesterol (= 0.009)

LDL cholesterol decreased from baseline to second follow-up, a favorable cardiometabolic change, but absolute values were not available in the excerpt.

lower high-density lipoprotein cholesterol (= 0.047)

HDL cholesterol decreased at follow-up. Because higher HDL is generally considered favorable, this was extracted as a potentially unfavorable lipid change.

lower log urine albumin to creatinine ratio (< 0.001)

Log urine albumin-to-creatinine ratio decreased from baseline to second follow-up, suggesting lower albuminuria in this pre-post analysis.

lower estimated glomerular filtration rate (< 0.001)

Estimated glomerular filtration rate decreased during follow-up. The authors noted this may reflect hemodynamic changes, medication effects, or underlying DKD progression, so interpretation is uncertain.

A packaged team-based care model for type 2 diabetes with early diabetic kidney disease, including personalized education, exercise management, dietary counseling, multimedia tools, and multidisciplinary follow-up.

Positive: 6; Negative: 2; No effect: 0; Mixed: 0

Extracted 8 outcome signals across the study

Most extracted markers moved favorably, but HDL cholesterol and eGFR decreased and causal attribution is limited by the design.

↓ Systolic and diastolic blood pressure decreased from baseline

Mostly intermediate or surrogate outcomes

A coordinated multidisciplinary care program may support better glycemic and cardiometabolic risk marker control in early DKD

Albuminuria improved, but eGFR declined modestly during follow-up and needs cautious interpretation

Medication changes occurred during the program, so non-drug education effects cannot be separated from treatment intensification

Lo WC, Huang YJ, Tasi YL, Chen JF, Mai HC, Hung YL, Chio YH, Chen CY, Ou YL, Chen SC. Analysis of the association of multidisciplinary team care and education intervention in patients with early-stage diabetic kidney disease in Taiwan. Endocr J. 2026;73(4):517-527. doi:10.1507/endocrj.ej25-0418

Retrospective design with no concurrent comparison group

Single-hospital setting limits generalizability

The packaged intervention prevents attribution to any one component

Long-term kidney failure or cardiovascular outcomes were not evaluated

In 355 people with type 2 diabetes and early diabetic kidney disease, a multidisciplinary care program was linked with improved HbA1c, blood pressure, lipids, and albuminuria.

↓ Total cholesterol, LDL cholesterol, and albuminuria decreased

The intervention included personalized education, exercise management, dietary counseling, and multimedia tools aimed at improving disease self-management.

Integrated multidisciplinary diabetes and early CKD care program

No control group (high): No parallel control group reported

Limited population scope (moderate): Narrow population scope

Limited safety reporting (moderate): Safety reporting depth: not_reported

Team-based diabetes care may improve blood sugar, blood pressure, and albuminuria

This Taiwan study reviewed outcomes after people with type 2 diabetes and early diabetic kidney disease joined an integrated care program. The program included education, exercise support, diet counseling, multimedia tools, and team follow-up. Several markers improved from baseline, but the study had no concurrent comparison group.

The study shows before-and-after changes, not definitive cause-and-effect evidence

Medication use changed during follow-up, which may partly explain the results

The program was delivered in one Taiwanese hospital system

The results may not apply to advanced chronic kidney disease

An integrated multidisciplinary care and education program for type 2 diabetes with early DKD.

Adults with type 2 diabetes and early-stage diabetic kidney disease

Patients receiving coordinated multidisciplinary care in a hospital or integrated outpatient setting

People needing combined support for glucose, blood pressure, lipid, and kidney risk management

Team-based diabetes care may improve blood sugar, blood pressure, and albuminuria

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