Impact of hybrid closed loop (HCL) systems on children and young people with type 1 diabetes

Magdy Ahmed; Aisha Aslam; Emrullah Arslan; Divyani Bhudia; Shubhangini Mishra; Kishore Baske; Prabhakaran Kalaivanan; Paramita Cefalli; Ashraf Gabr; Perveen Sultana; Niki Johnson; Evelien Gevers; Claire Hughes; Rathi Prasad; Ruben Willemsen; Pratik Shah

doi:10.1530/endoabs.111.P30

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Endocrine Abstracts (2025) 111 P30 | DOI: 10.1530/endoabs.111.P30

BSPED2025 Poster Presentations Diabetes 2 (10 abstracts)

Impact of hybrid closed loop (HCL) systems on children and young people with type 1 diabetes

Magdy Ahmed ¹ , Aisha Aslam ¹ , Emrullah Arslan ² , Divyani Bhudia ¹ , Shubhangini Mishra ¹ , Kishore Baske ² , Prabhakaran Kalaivanan ³ , Paramita Cefalli ³ , Ashraf Gabr ³ , Perveen Sultana ² , Niki Johnson ⁴ , Evelien Gevers ¹ , Claire Hughes ¹ , Rathi Prasad ¹ , Ruben Willemsen ¹ & Pratik Shah ¹

Author affiliations

¹Royal London Hospital, London, United Kingdom; ²Barts Health NHS Trust, London, United Kingdom; ³Whipps Cross University Hospital, London, United Kingdom; ⁴Newham University Hospital, London, United Kingdom

Introduction: Hybrid closed-loop (HCL) insulin pump systems are increasingly utilised in managing Type 1 Diabetes Mellitus (T1D) in Children and Young People (CYP). These systems aim to optimise glycaemic control by improving Time in Range (TIR), reducing HbA1c, and easing the burden of daily diabetes management.

Aim: This retrospective cohort study aimed to evaluate the impact of HCL insulin pump systems on glycaemic outcomes in CYP with T1D by assessing changes in TIR, HbA1c, and Time Below Range (TBR) before and after HCL initiation and comparing outcomes across different HCL pump types.

Methods: CYP with T1D from three paediatric diabetes centres within Barts Health NHS Trust (Royal London, Whipps Cross, and Newham Hospitals) who had transitioned to HCL systems since January 2022 and used them for at least 12 months were included. Data were collected retrospectively from clinical records, the Twinkle paediatric diabetes management system, and insulin pump downloads. Outcomes were compared before and at 2 weeks, 3 months, and 12 months post-HCL initiation. Patients with less than 12 months of HCL use or incomplete data were excluded.

Results: A total of 200 CYP were included (mean age 13.5 ± 3.9 years; 108 male, 92 female). Devices used were: Medtronic 670G (n = 10), Medtronic 780G (n = 26), Tandem T-Slim Control IQ (n = 21), Ypsomed CamAPS FX (n = 12), and Omnipod 5 (n = 131). The average duration of HCL use was 1.47 ± 0.5 years. HbA1c improved significantly from 65.3 mmol/mol pre-HCL to 57.2 mmol/mol at 3 months (p < 0.001) with sustained improvement at 12 months (56.4 mmol/mol, p < 0.001). TIR improved from 37.4% to 52.3% at 2 weeks (P = 0.004), 53.6% at 3 months, and 53.2% at 12 months (p < 0.001). TBR increased transiently at 2 weeks (2.6% ± 2.46, P = 0.10) compared to baseline (1.9% ± 2.66) but returned to baseline by 12 months (1.92% ± 2.0, P = 0.40).No significant differences between pump types (P = 0.45)

Conclusion: HCL systems significantly improved glycaemic control in CYP with T1DM. The results highlight the effectiveness of these systems in paediatric diabetes management and support the broad use of HCL in CYP with T1DM.