Real-World Use of Hybrid Closed-Loop System in Very Young Children with Type 1 Diabetes: Daily Glycemic Patterns Support Glycemic Improvements and Highlight Emerging Challenges for Hypoglycemia
Authors' conclusion
In real-life setting, HCL was associated with increased TIR and reduced TAR in very young children with T1D from the first month of use. The present study suggests that late morning is a high-risk window for hypoglycemia in this age group. This finding highlights the importance of optimizing HCL therapy settings and educating parents about specific times of the day that carry a higher risk of glycemic instability.
Study context
- Population
- Children under 6 years with T1D (diabetes duration ≥6 months) transitioning to CamAPS-FX-HCL
- Participants
- 72 participants
- Exposure
- CamAPS FX hybrid closed-loop (HCL) vs pre-HCL
- Outcome
- TIR70-180 change
- Follow-up
- Pre-HCL to 1 month post-HCL
Methodological detailspre-HCL vs post-HCL comparison, linear mixed models, Data collected pre-HCL and at 1, 3, 9 and 12 months after HCL initiation
- pre-HCL vs post-HCL comparison
- Linear mixed models
- Data collected pre-HCL and at 1, 3, 9 and 12 months after HCL initiation
Main finding
As reported in the abstract
Time in range (TIR70-180) increased (P < 0.001)
11% ± 8%
Target above range (TAR180) decreased (P < 0.001)
13% ± 9%
Observational data: associations, not effects.
Safety
Hypoglycaemia (TBR70/TBR54)
- TBR70 peak between 11 AM and 1 PM after HCL initiation; elevated risk persisted after 1 year
- 11% ± 9%
- TBR70/TBR54 similar before and after HCL (all P > 0.05)
Original publication
Real-World Use of Hybrid Closed-Loop System in Very Young Children with Type 1 Diabetes: Daily Glycemic Patterns Support Glycemic Improvements and Highlight Emerging Challenges for Hypoglycemia. Diabetes Technol Ther. Published 7 November 2025. doi:10.
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