Observational studyDiabetes care2023
Hybrid Closed-Loop Therapy in Adults With Type 1 Diabetes and Above-Target HbA1c: A Real-world Observational Study.
Observational study in Diabetes care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Early Worsening of Diabetic Retinopathy Following Initiation of Hybrid Closed-Loop/Automated Insulin Delivery Systems in Type 1 Diabetes: A Systematic Review and Structured Study-Level Synthesis.Diabetes, obesity & metabolism · 2026Pooled it
- Hybrid closed-loop insulin delivery improves glycaemic control compared with sensor-augmented pump therapy: A meta-analysis of 'free-living' randomised trials in type 1 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2026Pooled it
- Trial
- Diabetes-related acute care utilization following initiation of automated insulin delivery (AID): A comparison of a disposable tubeless AID system and durable tubed systems.Journal of managed care & specialty pharmacy · 2026Article
- BMI Normalization Is Associated With Lower Risk of Progression to Type 1 Diabetes, Primarily in Youth.Diabetes care · 2026Article
- A consensus statement on a National Competency Framework for training and assessment of knowledge and skills in diabetes technologies, including hybrid closed loop (HCL), insulin pump systems, and continuous glucose monitoring (CGM) devices.Diabetic medicine : a journal of the British Diabetic Association · 2026Article
- Clinical and quality of life outcomes in children and adolescents with type 1 diabetes using different insulin therapy types: a cross-sectional observational study.Diabetology & metabolic syndrome · 2026Article
- A retrospective observational study evaluating the safety and effectiveness of commercially available automated insulin delivery systems in people with type 1 diabetes and gastroparesis.Diabetes, obesity & metabolism · 2026Observational
- Letter to the Editor: 'Diabetes and technology - an update for the general physician'.Clinical medicine (London, England) · 2026Article
- Fully closed-loop systems: can people with type 1 diabetes just do it? Insights from open-source systems.Diabetologia · 2026Review
- Factors Associated With Time to Automated Insulin Delivery System Initiation in Adults With Type 1 Diabetes on Multiple Daily Injections.Journal of diabetes science and technology · 2026Article
- Article
- Physical activity (20 min) is a powerful adjunct to insulin for correcting hyperglycaemia in Type 1 diabetes: A paradigm shift.Diabetic medicine : a journal of the British Diabetic Association · 2026Article
- Effect of breaking up sitting with regular active breaks on glucose management and vascular function in adults with type 1 diabetes who use hybrid closed-loop insulin delivery systems: a randomised crossover trial protocol.BMJ open sport & exercise medicine · 2026Article
- Exploring the Use of Hybrid Closed-Loop Systems in People With Type 1 Diabetes and Their Partners: A Qualitative Evaluation From the NHS England Pilot.Journal of diabetes research · 2026Article
- What training and support do people need to make optimal use of automated insulin delivery systems: Interview study.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Artificial pancreas: the past and the future.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- Retrospective analysis of impact of automated insulin delivery technology on acute care utilisation from 2019 to 2021.Diabetic medicine : a journal of the British Diabetic Association · 2025Observational
- Hybrid closed-loop systems in UK type 1 diabetes care: National survey of healthcare professional awareness, confidence, and training needs.Diabetes, obesity & metabolism · 2025Article
- Generalized multi task learning framework for glucose forecasting and hypoglycemia detection using simulation to reality.NPJ digital medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 20 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe explored longitudinal changes associated with switching to hybrid closed-loop (HCL) insulin delivery systems in adults with type 1 diabetes and elevated HbA1c levels despite the use of intermittently scanned continuous glucose monitoring (isCGM) and insulin pump therapy. RESEARCH DESIGN AND
methodsWe undertook a pragmatic, preplanned observational study of participants included in the National Health Service England closed-loop pilot. Adults using isCGM and insulin pump across 31 diabetes centers in England with an HbA1c ≥8.5% who were willing to commence HCL therapy were included. Outcomes included change in HbA1c, sensor glucometrics, diabetes distress score, Gold score (hypoglycemia awareness), acute event rates, and user opinion of HCL.
resultsIn total, 570 HCL users were included (median age 40 [IQR 29-50] years, 67% female, and 85% White). Mean baseline HbA1c was 9.4 ± 0.9% (78.9 ± 9.1 mmol/mol) with a median follow-up of 5.1 (IQR 3.9-6.6) months. Of 520 users continuing HCL at follow-up, mean adjusted HbA1c reduced by 1.7% (95% CI 1.5, 1.8; P < 0.0001) (18.1 mmol/mol [95% CI 16.6, 19.6]; P < 0.0001). Time in range (70-180 mg/dL) increased from 34.2 to 61.9% (P < 0.001). Individuals with HbA1c of ≤58 mmol/mol rose from 0 to 39.4% (P < 0.0001), and those achieving ≥70% glucose time in range and <4% time below range increased from 0.8 to 28.2% (P < 0.0001). Almost all participants rated HCL therapy as having a positive impact on quality of life (94.7% [540 of 570]).
conclusionsUse of HCL is associated with improvements in HbA1c, time in range, hypoglycemia, and diabetes-related distress and quality of life in people with type 1 diabetes in the real world.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.