ISSN 1662-4009 (Online)

ESPE Yearbook of Paediatric Endocrinology (2019) 16 10.20 | DOI: 10.1530/ey.16.10.20

Reduced burden of diabetes and improved quality of life: Experiences from unrestricted day-and-night hybrid closed-loop use in very young children with type 1 diabetes

Musolino G, Dovc K, Boughton CK, Tauschmann M, Allen JM, Nagl , Fritsch M, Yong J, Metcalfe E, Schaeffer D, Fichelle M, Schierloh U, Thiele AG, Abt D, Kojzar H, Mader JK, Slegtenhorst S, Ashcroft N, Wilinska ME, Sibayan J, Cohen N, Kollman C, Hofer SE, Fröhlich-Reiterer E, Kapellen TM, Acerini CL, de Beaufort C, Campbell F, Rami-Merhar B, Hovorka R & Kidsap Consortium


University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Cambridge, UK


Pediatr Diabetes. 2019 May 29. doi: 10.1111/pedi.12872. [Epub ahead of print]

There might be many benefits arising from the artificial pancreas and other new technologies to deliver insulin and measure glucose levels. Whether or not such technological advances will improve the lives of children and families needs to be answered.

This study surveyed the experiences of parents/caregivers of 20 young children aged 1 to 7 years with type 1 diabetes (T1D), from a multinational trial, after two 3-week periods of unrestricted day-and-night hybrid closed-loop insulin therapy at home using the Cambridge FlorenceM system. Benefits, limitations, and improvements of closed-loop technology were explored.

Families reported reduced burden of diabetes management, less time spent managing diabetes, and improved quality of sleep with closed-loop. Interestingly, 90% of respondants felt less worried about their child’s glucose control using closed-loop. Size of study devices, battery performance and connectivity issues were identified as areas for improvement. Parents/caregivers wished for more options to input information to the system such as temporary glucose targets.

Parents/caregivers of young children reported important quality of life benefits associated with using closed-loop, supporting adoption of this technology. However, it is possible that these positive views might reflect the general high reliance on technology and social background of this small sample and trial setting. It remains to be explored whether or not this finding holds true in a larger cohort of families, including patients from lower education and low income settings.

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