If you’re living with type 1 diabetes, you may be wondering whether a hybrid closed-loop (HCL) insulin delivery system could help you. Unlike traditional insulin therapy, which requires constant manual adjustments, HCL systems do much of the work for you, reducing fluctuations and making diabetes management easier. These systems can be especially helpful if you often have high or low blood sugar.

One study found that HCL systems can manage blood sugar levels better than traditional insulin therapies for people with type 1 diabetes.

The study looked at the results of 28 clinical trials. Researchers found that people using HCL systems spent 10.9 to 21.6 more percentage points of time in their target blood sugar rates compared with those using traditional insulin therapy. They also spent less time with dangerously low blood sugar levels. This helped lower the risk of hypoglycemia.

If you’re wondering how an HCL system works and whether it might help you manage your type 1 diabetes, read on for an overview of these devices. These systems may not be the best choice for everyone with type 1 diabetes, so it’s important to learn about them before talking to your doctor.

What Is an HCL?

HCL systems are also called artificial pancreases and automated insulin delivery systems. They are wearable devices that include an insulin pump, a continuous glucose monitor (CGM), and a computer algorithm. The system uses CGM readings to automatically adjust the amount of insulin you receive in real time. This helps lower your risk of hyperglycemia and hypoglycemia (high and low blood sugar levels).

How Does an HCL Work?

The HCL system is designed to work like a real pancreas, which is why it’s also referred to as an artificial pancreas. The device tracks your blood glucose levels. It then uses this information to calculate how much insulin your body needs and delivers it automatically. This means you don’t have to check your blood sugar or give yourself insulin shots as often.

HCL devices can make blood sugar management much easier. They may also help improve your quality of life, because you’ll spend less time monitoring your blood glucose levels.

The system uses a continuous glucose monitor. A small sensor is placed under your skin to measure your blood sugar levels. An insulin pump then delivers insulin based on those readings.

Insulin pumps come in different forms. One type is worn outside the body. You might clip it to your belt, keep it in your pocket, or carry it in a pouch. A thin tube connects the pump to your body and delivers each dose of insulin through a small device placed under your skin. You’ll replace this tube every few days.

Another type of insulin pump is attached directly to your skin using an adhesive. It also delivers insulin through a small tube inserted under your skin. This type of pump isn’t permanent. Instead, you’ll replace it every few days.

Who Is a Candidate for an HCL?

Whether an HCL system is right for someone depends on their doctor’s evaluation and recommendation. These diabetes technology devices have been used successfully in people with type 1 diabetes from ages 2 through adulthood. Studies show that blood sugar control improves significantly across age groups and ethnic backgrounds after using an HCL system.

However, not every device is approved for very young children. It’s important to talk with your healthcare provider about the options available.

People using the HCL system, or their caregivers, need to be able to notice problems with the device and fix them. They also need to check that the system is working correctly. People who can’t do that or don’t have caregivers who can do it for them may not be strong HCL candidates. In addition, HCL candidates need access to a wireless internet connection so the different parts of the device can communicate with each other.

An HCL device tracks your blood glucose levels, calculates how much insulin you need, and delivers the insulin doses to your body.

In some cases, the HCL device may have trouble adjusting during exercises. This is because physical activity can alter blood glucose levels and insulin needs quickly, and the HCL device may not respond fast enough. If you exercise often, talk with your diabetes care team about whether an HCL is right for you.

What Are the Pros and Cons of an HCL?

HCL devices can make managing blood sugar much easier. They may also help improve your quality of life because you’ll spend less time monitoring your blood glucose levels. These systems can also help your doctor or caregivers monitor your CGM data remotely.

However, HCL systems can be expensive and require insurance approval. Because they require users to enter meal data and sometimes make manual adjustments, they may also be challenging for those less comfortable with technology.

Reach Out to Your Doctor

If you or a loved one is having trouble keeping glucose levels under control, talk with a healthcare provider. They can help you review treatment options and explain the pros and cons of HCL systems or other approaches. Together, you can choose a plan that fits your health needs, daily routine, and insurance coverage.

Learn more about treatment options for keeping glucose levels in check for type 1 diabetes.

Join the Conversation

On myT1Dteam, people share their experiences with type 1 diabetes, get advice, and find support from others who understand.

Have you tried a hybrid closed-loop system? Let others know in the comments below.