Diabetes Management and Research
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In this large, real-world cohort of CYP with high HbA1c, initiation of HCL therapy was associated with sustained improvements in glycaemic control and fewer diabetes-related hospital admissions, supporting its use in this high-risk population.
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OBJECTIVE: To evaluate changes in glycated haemoglobin (HbA1c) following initiation of hybrid closed-loop (HCL) insulin pump therapy in children and young people (CYP) with previously elevated HbA1c in a real-world multicentre setting. DESIGN: Retrospective multicentre observational cohort study. SETTING: 13 National Health Service paediatric diabetes units within a regional diabetes network in England, UK. PATIENTS: CYP aged ≤19 years with type 1 diabetes of more than 1 year's duration and HbA1c ≥69 mmol/mol at the time of HCL initiation and at least 3 months prior. INTERVENTIONS: Initiation of HCL insulin pump therapy. MAIN OUTCOME MEASURES: Primary outcome was change in HbA1c following HCL initiation. Secondary outcomes included subgroup and pump system comparisons and changes in diabetes-related hospital admissions. RESULTS: A total of 220 participants were included. HbA1c decreased significantly following HCL initiation (p 100 mmol/mol) and in participants transitioning from multiple daily injections. Outcomes were similar across HCL pump systems, and diabetes-related hospital admissions decreased overall following HCL initiation. CONCLUSIONS: In this large, real-world cohort of CYP with high HbA1c, initiation of HCL therapy was associated with sustained improvements in glycaemic control and fewer diabetes-related hospital admissions, supporting its use in this high-risk population.
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@article{King2026Real,
title = {Real-world outcomes of hybrid closed-loop insulin pump therapy in UK children and young people with type 1 diabetes and high HbA1c: a multicentre retrospective cohort study},
author = {Anna Caitlin King and Peter Christian and Paul Bassett and Edward Holloway},
journal = {Archives of Disease in Childhood},
year = {2026},
doi = {10.1136/archdischild-2026-330408},
url = {https://doi.org/10.1136/archdischild-2026-330408}
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