Abstract Aims Retrospective study evaluating real‐world outcomes of hybrid closed‐loop (HCL) in adults with type 1 diabetes and comorbid depression and/or anxiety disorders. Materials and methods Adults with type 1 diabetes and comorbid depression/anxiety disorders attending King's College Hospital diabetes centre between October 2023 and January 2025 were included. Demographic, medical and psychiatric information, acute diabetes complication rates, two‐item diabetes distress scale (DDS2) scores and sensor glucometrics (time in range; TIR) were extracted from electronic health records and diabetes technology platforms. Results Of 1827 adults with type 1 diabetes, 226 had comorbid depressive and/or anxiety disorders 163 female/63 male; age 38 (IQR: 29.0–51.3) years, 23 (15–33.3) years diabetes duration; 196 had depression and 119 had anxiety disorders. HCL‐users ( n = 108; 89 female/19 male) had lower glycated haemoglobin A 1c (HbA 1c ) and higher TIR HbA 1c 60.0 mmol/mol (7.6%) (53.0–66.0/7.0–8.2) vs. 73.0 mmol/mol (8.8%) (58.5–85.5/7.5–10.0), p < 0.001; TIR 63.5 (55.8–75.0) vs. 42.0 (23.0–55.3), p < 0.001 than non‐HCL users ( n = 118, 44 female/74 male) at last follow‐up compared to baseline. Glycaemia improved post HCL‐initiation compared to pre‐HCL HbA 1c 60.0 mmol/mol (7.6%) (53.0–66.0/7.0–8.2) vs. 67.5 mmol/mol (8.3%) (58.8–77.8/7.5–9.3), p < 0.001; TIR 63.5 (55.8–75.0) vs. 39.0 (28.0–55.8), p < 0.001. Severe hypoglycaemia rates did not vary ( p = 0.380), but fewer HCL users experienced ketoacidosis ( p < 0.001). DDS2 scores were lower post‐HCL ( p = 0.004) but not when comparing HCL and non‐HCL users ( p = 0.230). Conclusions HCL users demonstrated improved HbA 1c and TIR, compared with non‐HCL users. These real‐world data support safe use of HCL in people with type 1 diabetes and depression/anxiety in a multidisciplinary setting. Qualitative studies and prospective trials are required to further evaluate the impact of HCL on biomedical and mental health outcomes.
Croos et al. (Tue,) studied this question.