Hybrid closed-loop (HCL) glucose monitoring systems led to significant improvements in glycated hemoglobin (HbA1c) levels, time in target glucose range, and hypoglycemia risk among children and young people (CYP) with type 1 diabetes (T1D), according to a new study of real-world usage of HCL systems.1
New technology, like HCL systems, has dramatically changed daily management and monitoring of T1D. HCL systems use subcutaneous continuous glucose monitoring and an insulin pump to automatically manage patients’ glucose levels, lowering the risk of complications associated with uncontrolled blood glucose.
Key Takeaways
- Emerging diabetes technology, such as HCL systems, have revolutionized daily management of T1D by reducing the risk of complications associated with uncontrolled blood glucose.
- A real-world study showed that after 12 months of use, HCL systems led to improvements in HbA1c levels, time in target glucose range, and hypoglycemia risk among CYP with T1D.
- Investigators also noted that use of an HCL system led to unforeseen advantages, such as reduced fears of hypoglycemia and better quality of sleep, among patients.
In the United Kingdom, the National Health Service of England (NHSE) launched a pilot initiative designed to understand the impact of making HCL systems universally available to CYP. The new report, published in BMC Medicine, details the real-world impact of the systems on patients after 12 months.1
The investigators enrolled 251 CYP younger than 19 years who had T1D and were at least 1 year into their diagnosis. Participants needed to have at least 1 HbA1c measurement to be included in the study, and they were excluded if they had already been using an HCL or sensor-augmented pump prior to study enrollment. The study was conducted between August 2021 and December 2022 at 8 pediatric diabetes centers within the NHSE’s health system.
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The enrollees had a mean age of 12.3 years, male patients comprised a majority of the cohort (58%), and most of the participants were White (89%). Each patient was given 1 of 3 commercially available HCL systems, the costs of which were covered by the NHSE.
The systems led to significant improvement in a variety of categories, according to the study authors. HbA1c was reduced by 7 mmol/mol at 12 months (P < .001) and time in target glucose range increased by 13.4% on average (P < .001). Hypoglycemia rates dropped by half, the authors reported.
“These findings align with existing real-world data, suggesting the superiority of HCL systems in achieving target glucose range, preventing hypoglycemia, and reducing glycaemic variability,” the authors wrote.
However, they also noted that those direct health benefits led to indirect benefits in other health- and quality-of-life–related metrics. For instance, patients said they had less fear of hypoglycemia and better quality of sleep.
