Endocrine Abstracts

Background and Aim: Over the past years, hybrid closed-loop (HCL) systems have emerged as the state-of-the art treatment of type 1 diabetes (T1D), and there is sufficient evidence to support their safety and value. The aim of this review was to evaluate all the available literature regarding the impact of HCL systems on diabetes management compared to sensor augmented pump (SAP) systems.

Methods: An extensive literature search was conducted through electronic databases (PubMed, Scopus and CINAHL) with the terms ‘hybrid closed-loop systems, ‘automated insulin dosing systems, ‘sensor augmented pump systems’ and ‘time in range’. Articles published in English, until September 2022, were included; no other criteria on publication dates were set.

Results: A total of 29 studies were included. Eleven studies investigated the effect of the HCL system in adult patients, 7 studies in adult, adolescent, and pediatric patients and 11 studies in pediatric and adolescent patients. The HCL systems used were the Minimed 640G, Minimed 670G, Minimed 780G, Bionic pancreas, Diabeloop, Dana-i and Tandem t: slim. Twenty-seven studies showed statistically significant reduction in mean glucose and a significant increase in the percentage of time within target range in HCL group compared to SAP. In addition, a significant reduction in average HbA1c levels was reported by 14 studies in HCL group compared to the SAP group. Time spent in hyperglycemia and hypoglycemia were significantly reduced in HCL group in 15 studies.

Conclusions: Hybrid closed-loop insulin delivery systems provide better glycemic control and more time in range compared to SAP systems. Therefore, the HCL system represents an important treatment option for patients with T1D.