Improving HbA1c levels with advanced hybrid closed-loop therapy

Abstract

Closed-loop insulin delivery systems improve glucose outcomes for people living with type 1 diabetes, although the improvement in HbA1c has been modest. In a study by Brown and colleagues from 2021, a multicentre trial of Insulet's Ominpod 5 showed a reduction in HbA1c of –0·38 in adults, most of whom were previously on open loop pump therapy.1 Other studies of commercial closed-loop systems have similarly found modest reductions in HbA1c in the range of –0·2 to –0·5%.2,3 A possibility for such modest reductions in HbA1c could be because the participants in these studies—many of whom were on sensor-augmented pump therapy—already had well-controlled glucose before using the closed-loop system.