Insulin TherapyDevices & Monitoring
RESEARCH SUMMARY

Hybrid closed-loop artificial pancreas system improves blood sugar control better than insulin injections in hospitalized type 1 diabetes

Low confidence
very high bias
Last updated May 15, 2026

Key takeaway:

A 28-year-old woman with long-standing type 1 diabetes had better blood sugar control and fewer low blood sugar episodes when using a hybrid closed-loop artificial pancreas system compared to multiple insulin injections during a hospital stay.

Study at a glance

What was studied

Hybrid closed-loop artificial pancreas versus multiple insulin injections in hospitalized type 1 diabetes

Study type

non-randomized clinical trial (non-RCT or NRCT)

duration

Short-Term (≤3 mo)

Intervention

Hybrid closed-loop system

Outcomes

Time in range, Time below range, Blood glucose, Time above range, Hypoglycemia events, Glucose variability

Funding

Non-industry sponsored

Main effects

↑ Time in target range (3.9-10 mmol/L): increased from 65% to 87%

↓ Severe hypoglycemia: reduced from 1.8% to 0.4% of time

↓ Mean blood glucose: decreased from 8.03 to 6.93 mmol/L

evidence suggest

Evidence Suggest

  • HCL system significantly increased time in range compared to multiple daily injections (87% vs 65%, p<0.05)
  • Automated insulin delivery reduced severe low blood sugar events (glucose <3.0 mmol/L) by 78%
  • Blood sugar fluctuations were smoother throughout the day and night, especially after meals and during sleep
who this applies

Who this applies to

This case involved a 28-year-old woman with long-standing type 1 diabetes (17 years), elevated HbA1c (11.9%), history of poor glucose control, and frequent hypoglycemia. The findings may be most relevant for adults with type 1 diabetes who have difficulty achieving stable glucose control with insulin injections, particularly those experiencing frequent low blood sugar episodes.

keep in mind

Keep in Mind

This is a single case report, not a controlled study with multiple participants, so the results should be interpreted cautiously. The patient was hospitalized and closely monitored, which may not reflect typical outpatient care. The Android-based hybrid closed-loop system used is a do-it-yourself (DIY) system that is not commercially approved or regulated in China, and requires significant technical knowledge to set up and maintain. The cost of insulin pumps and CGM devices is not covered by medical insurance in China, limiting accessibility for most patients.

between the lines

Between the Lines

  • Case report of only one patient - results may not apply to all people with type 1 diabetes
  • Short observation period of just 7 days for each treatment method
  • Patient was hospitalized, so results may differ in outpatient or real-world settings
  • AndroidAPS system is not commercially approved in China and requires technical expertise to set up

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Journal Reference

Li S, Lv P, Lu H, et al. Initiation of Hybrid Closed-Loop Artificial Pancreas System Improves Glycemic Control in a Hospitalized Type 1 Diabetes: A Case Report and Review. Case Rep Endocrinol. 2026;2026:8925266. doi:10.1155/crie/8925266

Sources

Ranked by clinical relevance and evidence quality.

Key References

Most relevant evidence and guidance related to this research.

1
Guideline

ADA/EASD Consensus Report: The Management of Type 1 Diabetes in Adults

The 2021 ADA/EASD joint consensus acknowledges the safety and effectiveness of artificial pancreas systems in treating type 1 diabetes, noting that hybrid closed-loop systems can simulate pancreatic beta cell function and automatically adjust insulin delivery within preset glucose targets.
2
Guideline

ADA Standards of Care in Diabetes - Technology

The American Diabetes Association's clinical practice guidelines provide comprehensive recommendations for diabetes technology, including continuous glucose monitoring and automated insulin delivery systems for people with type 1 diabetes.
3
Guideline

Overview | t:slim X2 insulin pump for managing blood glucose levels in type 1 diabetes | Advice | NICE

NICE has developed a medtech innovation briefing (MIB) on t:slim X2 insulin pump for managing blood glucose levels in type 1 diabetes

13 total sources in this category

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