Smarter insulin pump systems help stabilize glucose in young patients, study reveals

By Dr. Sanchari Sinha Dutta, Ph.D.Reviewed by Lauren HardakerOct 22 2025

Children using advanced hybrid closed-loop insulin pumps achieved better glucose control, yet most failed to follow dietary and exercise guidelines, highlighting that technology alone cannot replace healthy lifestyle habits in diabetes management.

Study: Comparison of Metabolic Control, Dietary Habits, Activity, and Psychological Condition in Children and Adolescents Treated with Personal Insulin Pumps. Image Credit: Halfpoint / Shutterstock

Researchers at the University Clinical Center of Gdansk, Poland, conducted a study to explore metabolic control, eating habits, physical activity level, mental health, and quality of life in type 1 diabetic patients who use personal insulin pumps with predictive low glucose suspend or an advanced hybrid closed loop system. The findings are published in the journal Nutrients.

Background

Type 1 diabetes is a common chronic metabolic condition in children and adolescents. Destruction of pancreatic beta cells is the primary cause of type 1 diabetes, which results in absolute insulin deficiency and impaired blood glucose regulation. The disease is associated with a higher risk of mortality.

In Poland, more than 20,000 children and adolescents currently live with type 1 diabetes. The disease incidence has increased approximately 1.5-fold in these populations over the past five years. This increasing trend has raised significant public health concerns.

Insulin pumps with predictive low glucose suspend or advanced hybrid closed loop systems are widely used in Poland to treat pediatric patients with type 1 diabetes. Predictive low glucose suspend system-enabled pumps suspend insulin delivery when glucose levels fall and restart once glucose levels are normalized. Advanced hybrid closed-loop (AHCL) systems, representing the latest automated insulin delivery technology, use control algorithms to automate basal insulin delivery based on glucose sensor values, and prior research indicates they have been shown to improve metabolic control and restore hypoglycemia awareness in pediatric populations. Both pump types help maintain metabolic control and reduce hypoglycemia risk (low blood glucose level).

Besides lifelong insulin therapy, long-term management of type 1 diabetes is associated with healthy dietary habits and regular physical activity. These two lifestyle factors significantly influence metabolic control in type 1 diabetic patients. Metabolic control of diabetes refers to the maintenance of metabolic parameters such as blood glucose, glycated hemoglobin (a measure of glycemic control), lipid profile, body weight, and blood pressure within recommended target ranges.

Psychological factors are also closely related to metabolic control in type 1 diabetes. In pediatric patients with type 1 diabetes, depressive symptoms and disease-related distress have been found to associate with poor glycemic outcomes.

Given the multifactorial management of type 1 diabetes, researchers at the University Clinical Center of Gdansk, Poland, in collaboration with biostatisticians from the Medical University of Lodz, conducted a study to compare metabolic control, eating habits, physical activity, and mental health in pediatric type 1 diabetes patients who used insulin pumps with predictive low glucose suspend and advanced hybrid closed loop systems.

Key findings

A total of 37 pediatric patients (16 female, 21 male) participated in this study. Of them, 21 used insulin pumps with an advanced hybrid closed-loop system, and 16 used a predictive low glucose suspend system. All patients participated in culinary workshops, which included hands-on education on low-glycemic-index meal preparation and carbohydrate counting.

Regarding metabolic control, the analysis revealed that patients using an advanced hybrid closed-loop system achieved significantly better glycemic control across multiple metrics compared to those using a predictive low glucose suspend system. These improvements included lower mean glucose, reduced glucose variability, more time in the target range (70–180 mg/dL), and less time in hypoglycemic and hyperglycemic ranges.

The dietary assessment revealed that patients from both insulin pump categories did not follow nutritional recommendations and consumed high-carbohydrate diets, as well as sweet snacks and beverages. A statistically significant correlation showed more frequent consumption of juices or sugary drinks in patients who spent more time in hypoglycemia. The researchers noted this might reflect patients using sugary drinks to treat lows, but emphasized hypoglycemia could also result from other factors like insulin dosing errors or inaccurate carbohydrate counting.

Regarding other parameters, the analysis revealed a lack of physical activity among participants from both insulin pump categories. Similarly, no significant difference in diabetes-specific quality of life (PedsQL) mental health status was observed between the two categories.

Study significance

The study reports that insulin pumps with an advanced hybrid closed-loop system demonstrate superior effectiveness to pumps with a predictive low glucose suspend system in improving multiple glycemic control metrics and reducing hypoglycemia and hyperglycemia exposure.

These findings suggest pediatric patients using AHCL systems may have lower risks of developing acute or chronic diabetes-related complications.

Notably, the study findings indicate that type 1 diabetic patients typically do not follow recommended dietary and physical activity guidelines, which likely contributes to suboptimal metabolic control regardless of pump technology. These findings highlight the need for improving awareness among pediatric patients and their families about the importance of healthy nutrition and daily exercise in diabetes management.

Several studies have highlighted the importance of a well-balanced, low-glycemic-index diet in optimizing pump therapy and improving glycemic control in children and adolescents with type 1 diabetes.

The study had several limitations, including its small sample size, reliance on self-reported dietary/activity data, single timepoint assessment, lack of baseline HbA1c, and short 3-month observation period. All participants received dietary education during workshops, which may have minimized group differences.