Challenge of managing type 1 diabetes in young children eased by hybrid closed loop technology

Sometimes known as an artificial pancreas, hybrid closed loop systems combine a continuous glucose monitor (CGM) and an insulin pump to deliver insulin automatically.  

This is done with the help of an algorithm, which takes glucose level data from the CGM and calculates how much insulin the pump should give.  

The new study compared data from children using a hybrid closed loop system, to data from children using a CGM and insulin pump independently of one another.  

The data showed that the children on hybrid closed loop therapy did better, spending an extra two hours a day in their target glucose range and having lower HbA1c levels after 16 weeks. 

Keeping blood glucose levels within their recommended range is one way to reduce the risk of developing complications from type 1 diabetes. 

JDRF pushing for access to hybrid closed loop technology 

This study is yet another to show how technology can remove some of the burden of type 1 diabetes. 

Our research has previously revealed how hybrid closed loop systems support blood glucose management in a wide range of people and situations – including pregnant women and children doing exercise.  

JDRF research was also the first to show that continuous glucose monitoring technology helps prevent dangerous blood glucose highs and lows, and later showed that CGM significantly benefits both mother and child during pregnancy. 

These studies have since led to the development and NHS availability of multiple systems. 

For example, the hybrid closed loop system used in this research, CamAPS FX, is based on more than a decade of JDRF-funded research by Professor Roman Hovorka.  

The system launched in the UK in 2020 – and in 2021 became part of a pilot programme to determine if artificial pancreas technology should be funded on the NHS. 

Also in 2020, NHS England began providing CGM to all pregnant women living with type 1 diabetes. 

Life-changing tech for people affected type 1 diabetes

Conor McKeever, Research Communications Manager at Breakthrough T1D UK, said: “This is even more evidence that hybrid closed loop technology can benefit a range of people with type 1 diabetes. 

“Managing type 1 is a challenge at any age, but it is extremely difficult in young children. Hybrid closed loop technology can help these kids be kids, and reduce some of the worry that their parents and carers carry all day and night.  

“As type 1 diabetes technology continues to advance, we will be pushing for wider access to these life-changing treatments.” 

Dr Julia Ware, the study’s first author, said: “Very young children are extremely vulnerable to changes in their blood sugar levels. High levels in particular can have potentially lasting consequences to their brain development. On top of that, diabetes is very challenging to manage in this age group, creating a huge burden for families.

“CamAPS FX led to improvements in several measures, including hyperglycaemia and average blood sugar levels, without increasing the risk of hypos. This is likely to have important benefits for those children who use it.”

She added that the children’s parents and carers found the technology ‘life-changing’, saying: “They tell us it gives them more time to do what any ‘normal’ family can do, to play and do fun things with their children.”

The research was published in the New England Journal of Medicine.