Artificial Pancreas

What is a hybrid closed-loop system

• A hybrid closed-loop (HCL) system links a continuous glucose monitor (CGM) + an insulin pump + an algorithm to automatically adjust basal insulin delivery. You still must manual input things like carbohydrate intake and exercise. NHS England+4Diabetes UK+4NHS England+4

• In the UK these are sometimes called an “artificial pancreas” in lay terms. NHS England+1

• National guidance from National Institute for Health and Care Excellence (NICE) issued final recommendations 19 Dec 2023 for use in Type 1 diabetes

  
  

  Who is eligible in the UK (England/Wales)

  Per NICE and the rollout plan by NHS England:

  • Children and young people (under 18) with Type 1 diabetes. NHS England+2nhs.uk+2

  • Adults with Type 1 diabetes who have HbA1c ≥ 58 mmol/mol (≈ 7.5 %) or disabling hypoglycaemia despite best possible management (e.g., pump or CGM already). NHS England+2NICE+2

  • Women (and trans men / non-binary people) with Type 1 diabetes who are pregnant or planning pregnancy. NHS England+1

  • Roll-out is phased: beginning April 2024 with priority groups, with full rollout over ~5 years.

    
    

    Which HCL systems are available in the UK

    According to up-to-date UK sources, the following HCL systems are available or licensed in the UK (either via NHS or self-funding) for people with Type 1 diabetes: Diabetes UK+2Breakthrough T1D UK+2

System	Components / Notes
Omnipod 5	Tubeless patch-pump; works with Dexcom G6, Dexcom G7 and Freestyle Libre 2 Plus; licensed from age 2+. Diabetes UK
Dana i (with CamAPS FX algorithm)	Insulin pump + algorithm; works with Dexcom G6; licensed from age 1+ and for use in pregnancy. Diabetes UK
Medtronic 780G	Insulin pump + algorithm (SmartGuard); works with Guardian 4 & Simplera Sync CGM; licensed for age 7-80. Diabetes UK
Tandem t:slim X2 (Control-IQ)	Works with Dexcom G6 / G7 CGM; licensed from age 6+. Diabetes UK+1
mylife YpsoPump (with CamAPS FX algorithm)	Works with Dexcom G6 and Freestyle Libre 3 CGM; part of HCL offerings.

Additional important details & caveats

• Even with HCL systems, users still need to input meals/carbs/exercise and monitor their device. These are hybrid, not fully automated. Diabetes UK

• The availability through the NHS depends on local NHS trust readiness, specialist staff, training etc. Even if you meet eligibility, there might be wait times. NHS England+1

• If you don’t meet NHS criteria (yet) you may consider self-funding an HCL system. Diabetes UK+1

• Device compatibility matters: CGM + pump + algorithm must be able to “talk” to each other. Not all combinations work. Breakthrough T1D UK+1

• Costs (when self-funding) are significant per Diabetes UK figures: pump £2,000-3,000 plus ~£1,500/year, CGM about £2,000/year.