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Minerva Pediatrics 2021 Jul 26

DOI: 10.23736/S2724-5276.21.06531-9


language: English

Efficacy of advanced hybrid closed loop systems for the management of type 1 diabetes in children

Lucia FERRITO 1, Stefano PASSANISI 2, Riccardo BONFANTI 3, Valentino CHERUBINI 4, Nicola MINUTO 5, Riccardo SCHIAFFINI 6, Andrea SCARAMUZZA 7

1 Division of Pediatrics and Neonatology, Senigallia Hospital, Senigallia, Ancona, Italy; 2 Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy; 3 Diabetes Research Institute, Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Milano, Italy; 4 Department of Women’s and Children’s Health, G. Salesi Hospital, Ancona, Italy; 5 Pediatric Clinic, IRCCS G. Gaslini, Genova, Italy; 6 Diabetes Unit, Pediatric Hospital Bambino Gesù, Roma, Italy; 7 Division of Pediatrics, ASST Cremona, Cremona, Italy


Over the last years significant advances have been achieved in the development of technologies for diabetes management. Continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), predictive low glucose management (PLGM), hybrid closed loop (HCL) and advanced hybrid closed loop (AHCL) systems allow better diabetes management, thus reducing the burden of the disease and the risk of chronic complications. This review summarizes the main characteristics of the currently available HCL and AHCL systems and their primary effects in children and adolescents with type 1 diabetes (T1D). The findings of trials assessing the glucose control (time in range, HbA1c values, hypoglycemic events), the health-related quality of life and the existing limits of the use of these technologies are reported. The most recent data clearly confirm the ability of the HCL and AHCL insulin delivery systems to safely achieve a significant improvement of glucose control and quality of life in the pediatric population with T1D. Further studies are underway to overcame current barriers and future improvements in the usability of these technologies are awaited to facilitate their use in the routine clinical practice. The HCL and AHCL algorithms are the key features of today’s insulin delivery systems that mark a crucial step towards fully automated closed loop systems.

KEY WORDS: Artificial pancreas; Hybrid closed loop (HCL); Advanced hybrid closed loop (AHCL); Type 1 diabetes; Children; Diabetes technology

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