Three-Year Real-World Performance of Bihormonal Fully Closed-Loop Therapy in Type 1 Diabetes
Authors' conclusion
Real-world data demonstrated long-term stability of bihormonal FCL system performance among individuals treated with GG. A slight decline in performance was observed in the total population, and outcomes significantly deteriorated for users after the glucagon switch, indicating a negative effect on FCL performance of the alternative glucagon.
Study context
- Population
- Adults with T1D treated with the bihormonal fully closed-loop (FCL) system for 3 years
- Participants
- 102 adults
- Exposure
- GG-only users vs total group of bihormonal FCL users
- GG-onlyn = 60
- Outcome
- TIR (3.9-10.0 mmol/L [70-180 mg/dL]) per semester
- Follow-up
- 3 years
Methodological detailsobservational, real-world, Linear mixed-effects models to evaluate changes over time
- Observational
- Real-world
- Linear mixed-effects models to evaluate changes over time
Main finding
As reported in the abstract
GG-only
79.5% to 80.8%
Total
77.4% to 80.8%
Observational data: associations, not effects.
Further findings
| Outcome | GG-only | Total | P value |
|---|---|---|---|
| Time below range (<3.9 mmol/L [<70 mg/dL]) per semester · 3 years | 0.95%-1.56% | 1.03%-1.69% | |
| TIR in 3 months after vs before glucagon switch · 3-month period | P < 0.001 |
- Time in range (TIR) in 3 months after vs before glucagon switch: Before switch 79.3 ± 7.1
- TIR in 3 months after vs before glucagon switch: After switch 75.8 ± 7.9
Original publication
Three-Year Real-World Performance of Bihormonal Fully Closed-Loop Therapy in Type 1 Diabetes. Diabetes Technol Ther. Published 24 September 2026. doi:10.
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