EFFECTIVENESS OF HYBRID CLOSED-LOOP SYSTEMS IN PEDIATRIC TYPE 1 DIABETES MELLITUS MANAGEMENT: A SYSTEMATIC REVIEW

Justyna Grudziąż-Sękowska; Kuba Sękowski; Zuzanna Grześczyk-Nojszewska; Jarosław Pinkas; Janusz Ostrowski; Mateusz Jankowski

doi:10.5114/hpc.2025.151047

eISSN: 2354-0265
ISSN: 2353-6942

Health Problems of Civilization Physical activity: diseases and issues recognized by the WHO

Current issue Archive Online first About the journal Editorial board Reviewers Abstracting and indexing Contact Instructions for authors Publication charge Ethical standards and procedures

Editorial System

Submit your Manuscript

Editorial Policies

Sarajevo Declaration on Integrity and Visibility of Scholarly Publications

Open access

Send email

Copy url:

abstract:

Review paper

EFFECTIVENESS OF HYBRID CLOSED-LOOP SYSTEMS IN PEDIATRIC TYPE 1 DIABETES MELLITUS MANAGEMENT: A SYSTEMATIC REVIEW

Justyna Grudziąż-Sękowska

¹

,

Kuba Sękowski

¹

,

Zuzanna Grześczyk-Nojszewska

¹

,

Jarosław Pinkas

¹

,

Janusz Ostrowski

¹

,

Mateusz Jankowski

¹

Public Health School, Centre of Postgraduate Medical Education, Warsaw, Poland

Health Problems of Civilization

DOI: https://doi.org/10.5114/hpc.2025.151047

Online publish date: 2025/05/19

View full text Get citation

PlumX metrics:

This systematic review synthesizes findings from 45 studies (2019-2024) on hybrid closed-loop (HCL) systems in pediatric type 1 diabetes (T1D). Consistent improvements in glycemic control were observed, with time-in-range (TIR, 70-180 mg/dL) increasing by 6.7-36.7 percentage points, particularly among patients transitioning from multiple daily injections. Adolescents benefited more than younger children (18.4% vs. 14.3% TIR increase, p=0.01), with nighttime control improving significantly (23.6% TIR increase, p<0.001). HbA1c reductions reached clinical significance in 68% of studies, and the likelihood of achieving HbA1c ≤6.5% tripled with HCL use (OR=3.03, p<0.001). Hyperglycemia (>250 mg/dL) decreased by up to 81%, while hypoglycemia (<70 mg/dL) showed modest but consistent reductions. Preliminary neurodevelopmental findings indicated improved brain structure metrics. However, disparities persist: only 30% of studies included underrepresented groups, and real-world data showed 21% lower HCL adoption in low-income populations. Device efficacy depended on usage patterns, with optimal TIR requiring ≥85% engagement in automated mode. Despite their transformative potential, HCL systems face challenges related to access and variability in response. Future research should focus on long-term outcomes, standardized metrics, and AI-driven personalization to enhance pediatric diabetes management.

keywords:

EFFECTIVENESS OF HYBRID CLOSED-LOOP SYSTEMS IN PEDIATRIC TYPE 1 DIABETES MELLITUS MANAGEMENT: A SYSTEMATIC REVIEW

Justyna Grudziąż-Sękowska 1 , Kuba Sękowski 1 , Zuzanna Grześczyk-Nojszewska 1 , Jarosław Pinkas 1 , Janusz Ostrowski 1 , Mateusz Jankowski 1

artificial pancreas, insulin infusion systems, blood glucose self-monitoring, type 1 diabetes mellitus, pediatrics

Justyna Grudziąż-Sękowska

¹

,

Kuba Sękowski

¹

,

Zuzanna Grześczyk-Nojszewska

¹

,

Jarosław Pinkas

¹

,

Janusz Ostrowski

¹

,

Mateusz Jankowski

¹