Hybrid closed loop research

Take a look at how we’ve driven research forward and worked to get it in the hands of people with type 1, from funding programmes that sparked the early development of hybrid closed loop to working with the NHS to widen access to the technology.

Our early research in Cambridge

Since 2006 we have given four research grants to Professor Roman Hovorka at the University of Cambridge, who is a specialist in creating computer programmes that mimic how the body works.

Professor Roman Hovorka, who we funded to develop a hybrid closed loop system

Thanks to our funding, Professor Hovorka developed a hybrid closed loop system called CamAPS FX, which is an app that links continuous glucose monitors (CGM) with insulin pumps. The CamAPS FX app means that a CGM can work with an insulin pump using a complex algorithm to automatically deliver insulin to people with type 1.

Testing the hybrid closed loop system

With our ongoing funding, Professor Hovorka’s team tested their hybrid closed loop model on a range of ages, under various conditions, to ensure as many people as possible could benefit from the technology.

Babies as young as one, children, adolescents, adults, older adults and pregnant people with type 1 all took part in Breakthrough T1D UK-funded clinical trials of hybrid closed loop. The trials tested how well the system worked under normal living conditions during the day and overnight. The research team also stress-tested the system following exercise and alcohol consumption in adults with type 1 diabetes.

Exploring clinicians’ attitudes to hybrid closed loop technology

Then, in 2017 we gave Dr Conor Farrington at University of Cambridge funding to research how clinicians view hybrid closed loop systems. Dr Farrington interviewed a range of diabetes clinicians about the barriers and opportunities of HCL. He found that clinicians recognised the benefits of closed loop systems but had some concerns for both people with type 1 and healthcare professionals.  

This Breakthrough T1D UK-funded research identified the barriers to getting the technology to people with type 1, and looked at how we could overcome those barriers to make sure hybrid closed loop could be adopted by the NHS. This was a crucial step to getting this technology into the hands of the many thousands of people it has the potential to help. 

Hybrid closed loop app licensed in 2020

Backed by 13 years of clinical research, Professor Roman Hovorka’s hybrid closed loop app launched in March 2020, making it the world’s first licensed, downloadable hybrid closed loop app for people with type 1 diabetes. The commercial launch was a milestone in the journey towards full artificial pancreas technology for everyone with type 1 diabetes.

An illustration of the CamAPS FX hybrid closed loop system

Limited access to hybrid closed loop technology

The CamAPS FX hybrid closed loop app is available from £70 per month, and only for those with an Android device, Dexcom G6 CGM and Dana RS insulin pump. This limits who can currently access the technology. So, alongside Professor Hovorka we have been working with the NHS to make hybrid closed loop available to more people. 

Other hybrid closed loop systems

By funding Professor Hovorka’s pioneering research, we sparked other research groups and organisations to develop their own hybrid closed loop systems. There are now five systems available in the UK that use different combinations of CGMs and insulin pumps.

Pilot programme by the NHS

To test the feasibility of providing HCL systems on the NHS, the NHS ran a successful pilot of several hybrid closed loop systems with around a thousand people with type 1 in England and Wales. With the pilot complete, NICE released draft guidelines in January 2023 that recommend HCL systems for around 100,000 people with type 1 in England and Wales.