The closed-loop insulin system, sometimes called an artificial pancreas, represents the most significant advance in Type 1 diabetes management technology over the past decade. It combines a continuous glucose monitor with an insulin pump and an algorithm that automatically adjusts insulin delivery in real time based on glucose readings — without requiring constant manual input from the family.
Who is it for: Children who are already using an insulin pump and CGM and whose families are comfortable with the technology — typically after settling into pump therapy first
Available in India: Yes. Closed-loop systems are available in India, though device selection and cost vary. I discuss available options with families during consultations
Benefits: Significant improvement in time in range, reduction in hypoglycaemia, and reduced overnight parental burden — particularly transformative for families doing manual overnight checks
Not suitable for everyone: Younger children, newly diagnosed patients, or those not yet on pump therapy are typically not the starting point for closed-loop systems
In a standard insulin pump, the pump delivers insulin at rates set by the family and the diabetes team, but the family must manually adjust the dose when glucose changes. In a closed-loop system, the algorithm continuously analyses CGM data and increases or decreases insulin delivery automatically to keep glucose in range. This dramatically reduces the time parents spend managing glucose manually, improves time in range, and reduces the risk of overnight hypoglycaemia.
I discuss closed-loop systems with families at Hulse Clinic, JP Nagar, Bengaluru once they are settled into their initial insulin management and when the child and family are ready for this next level of technology.
Written by Dr Anjana Hulse, MBBS (Rajiv Gandhi University), MRCPCH (Royal College of Paediatrics and Child Health, UK), MSc Paediatric Endocrinology (University of Glasgow, passed with distinction), Consultant Paediatrician and Paediatric Endocrinologist, Hulse Clinic, 635, 8th Main Road, Near
