Hybrid Closed-Loop Technology: Diabetes Questions and Answers

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Hybrid Closed-Loop Technology: Diabetes Questions and Answers

Q: I heard that there are now pumps that automatically adjust insulin based on continuous glucose monitor (CGM) data. Does this mean that diabetes is cured? If so, how do I get one?

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A: I wish it were that simple. While it is true that some insulin pumps can automatically adjust insulin delivery, we are still a long way from a cure. The systems that are currently available utilize “hybrid closed-loop” technology. In other words, the pump takes data from a continuous glucose monitor and adjusts the basal insulin if the glucose is trending high or low. Some devices will administer doses of insulin all at once (boluses) to fix high readings. By “touching up” glucose levels around-the-clock, these systems are pretty good at helping users avoid dangerous highs and lows and spend more time within a healthy glucose range.

But these systems cannot act alone. While they are effective at fixing glucose levels that are trending up or down gradually, they are not so good at handling rapid rises and falls — the kind that occur with food (particularly carbohydrates), exercise, stress, illness, and hormonal changes. The user of the system is still responsible for making their own decisions and adjustments for these types of events.

Presently, FDA-approved hybrid closed-loop systems are available from Tandem (t:slim X2 insulin pump with Control-IQ technology), Medtronic (Medtronic MiniMed 670G Hybrid Closed-Loop System), and Insulet (Omnipod 5 Automated Insulin Delivery System). If you’re interested in learning more, your doctor or diabetes educator can help you review the differences between and features of the systems and determine which might be the best fit for your situation.

Want to learn more about hybrid closed-loop technology? Read “Hybrid Closed-Loop Insulin Pump Systems.”

Gary Scheiner, MS, CDCES

Gary Scheiner, MS, CDCES

Gary Scheiner, MS, CDCES on social media

The Owner and Clinical Director of Integrated Diabetes Services LLC, a private practice specializing in advanced education and glucose regulation for patients utilizing intensive insulin therapy. Scheiner, who has had Type 1 diabetes since 1985, was the AADE 2014 Diabetes Educator of the Year. He is the author of Think Like A Pancreas — A Practical Guide to Managing Diabetes With Insulin, Practical CGM, Diabetes-How To Help (A Guide to Caring for a Loved One With Diabetes), The Ultimate Guide to Accurate Carb Counting, and Until There Is A Cure.

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