Extended-Wear Insulin Infusion Sets in People with Type 1 Diabetes: A Scoping Review

Background/Objectives: Infusion sets are essential for continuous subcutaneous insulin infusion. Conventional sets require replacement every 2–3 days, while recent research has focused on extending wear time to reduce treatment burden and support automated insulin delivery. We aimed to characterize evidence on extended-wear infusion sets (>3 and ≤7 days) in people with type 1 diabetes (T1D), focusing on survival, safety, insulin delivery, glycemic outcomes, pharmacokinetic/pharmacodynamic parameters, and user experience. Methods: A scoping review was conducted according to PRISMA-ScR. The protocol was registered in the Open Science Framework (OSF; DOI: 10.17605/OSF.IO/TNKJ5). MEDLINE/PubMed, Embase, Scopus, Web of Science Core Collection, and Cochrane CENTRAL were searched for studies published from 1 January 2020 to 4 September 2026. Eligible studies evaluated infusion sets worn for >3 days in people with T1D and reported extended-wear outcomes. Results: Of 229 records identified, 103 unique references were screened and 11 underwent full-text assessment. Ten publications met the inclusion criteria, representing 9 independent sources of evidence. In the largest studies, 7-day set survival ranged from 77.8% to 95%, depending on device and failure criteria. Some studies reported deterioration in glycemic or pharmacodynamic measures with prolonged wear, whereas others showed good tolerability and reduced burden from set changes. Conclusions: Extended-wear infusion sets can remain functional for 4–7 days in a substantial proportion of people with T1D, although performance may decline with increasing wear time. Evidence is limited by heterogeneity in devices and study designs, small samples, few direct comparisons, and difficulty isolating the infusion set effect from other technological components. Independent comparative studies are needed to establish safety, insulin delivery stability, and clinical benefit.