Clinical and Economic Impact of Hybrid Closed-Loop Systems for T1 Diabetes Management in Spain
Chico, Ana 
(Institut de Recerca Sant Pau)
Moreno-Fernández, Jesús 
(Hospital General Universitario de Ciudad Real)
Khan-Mirón, Aesha (Ypsomed Diabetes Care AG)
Syleouni, Maria Eleni (Ypsomed Diabetes Care AG)
Brusaferri, Giovanni (Ypsomed Diabetes Care AG)
Nyffeler, Myriel (Nyffeler Scientific Marketing GmbH)
Beato-Víbora, Pilar I. (Universidad de Extremadura)
Universitat Autònoma de Barcelona.
Departament de Medicina
| Data: |
2025 |
| Resum: |
Objective: The main challenge in type 1 diabetes mellitus management is achieving and maintaining glycemic control. Hybrid closed-loop (HCL) systems offer patients the potential to safely achieve tight glycemic targets. This study analyzed the clinical and economic impact of HCL systems compared with intermittently scanned continuous glucose monitoring (is-CGM) and continuous subcutaneous insulin infusion (CSII) therapy from the Spanish health care system perspective. Methods: IQVIA Core Diabetes Model v10. 0 was used to simulate a cohort of 1000 individuals assigned to either the HCL or is-CGM+CSII therapy. Different time horizons were analyzed: 5, 15, 30, and 50 years. Cohort characteristics were extracted from published literature, and a 1. 5% glycated hemoglobin A1C reduction was considered for the HCL group over is-CGM+CSII. Results: In the HCL group, complications were averted or delayed across all time horizons whereas survival, quality of life, and cost savings were increased. At 50 years, HCL group survival was double than the comparator and 1. 15 incremental quality-adjusted life years were gained. Cost savings were the highest at 50 years (28 704 922€/1000 individuals) mostly attributable to lower amputation, ulcer, and nephrological event rates. The current study is based on real-world evidence data with a median follow-up of 5. 1 months. Thus, the long-term projections of clinical and economic outcomes may be affected by uncertainty. Additionally, the study did not include any hypoglycemia or diabetic ketoacidosis rates, which may lead to underestimation of the real impact of HCL systems. Conclusion: HCL systems should be considered the primary treatment option compared with is-CGM+CSII therapy for people with type 1 diabetes mellitus in Spain. |
| Drets: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Llengua: |
Anglès |
| Document: |
Article ; recerca ; Versió publicada |
| Matèria: |
Spain ;
automated insulin delivery ;
clinical impact ;
economic impact ;
hybrid closed-loop ;
type 1 diabetes mellitus |
| Publicat a: |
Endocrine Practice, Vol. 31, Num. 12 (December 2025) , p. 1530-1537, ISSN 1934-2403 |
DOI: 10.1016/j.eprac.2025.08.002
PMID: 40774615
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Registre creat el 2026-07-16, darrera modificació el 2026-07-19