Hybrid closed-loop artificial pancreas system improves blood sugar control better than insulin injections in hospitalized type 1 diabetes
Last updated May 15, 2026
Key finding
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.
This case report examined a woman with type 1 diabetes who switched between using an artificial pancreas system (which automatically adjusts insulin delivery) and traditional insulin injections while hospitalized. The artificial pancreas kept blood sugar in the target range 87% of the time compared to only 65% with injections, and caused fewer dangerous low blood sugar events.
Quick read
Study at a glance
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EvidenceScore™
Low
Study type
non-randomized clinical trial (non-RCT or NRCT)
Follow-up
Short-Term (≤3 mo)
Risk of bias
High Risk
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
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.
Published in
Journal Reference
Publication details and source links for this paper.
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
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
- 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 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
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
- 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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