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"Hybrid closed-loop" systems for blood glucose control: another way of delivering intensive insulin therapy

"Hybrid closed-loop" systems for blood glucose control in type 1 diabetes appear to maintain blood glucose close to physiological levels slightly more of the time than a "conventional" insulin pump, in particular at night. However, they also appear to slightly increase the incidence of hyperglycaemic episodes, mainly through malfunctions.
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The development of semi-automated insulin infusion systems (sometimes misleadingly referred to as an "artificial pancreas") began in the early 2000s, with the aim of improving glycaemic control and reducing the day-to-day burden of type 1 diabetes and its management.

As of 2023, three hybrid closed-loop systems for blood glucose control in type 1 diabetes have been evaluated by France's National Authority for Health (HAS): the Control-IQ°, DBLG1° and Minimed 780G° systems. In these three systems, intervention by the patient or carer remains necessary, in particular to enter data about physical activity, sugar administration and meals, and to confirm or refuse administration of an insulin bolus.

©Prescrire 1 July 2023

Source: ""Hybrid closed-loop" systems for blood glucose control in type 1 diabetes" Prescrire International 2023; 32 (250): 190-194. Subscribers only.

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