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Updated: Aug 17, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients' behaviour that challenges
Angela Zanfardino1, Alessia Piscopo1, Pietro Gizzone1
1Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy.
Objectives:
Hybrid closed loop systems (HCL) improve the management of type 1 diabetes (T1DM). T1DM adolescent patients represent a risk category also if they are in an automated insulin infusion delivery therapy.
Case Presentation:
We describe a series of four cases in which adolescent patients have adopted incorrect behaviours in the managing of HCL systems, challenging the algorithm skills. Two patients performed fabricated sensor calibrations. The other two did not perform pre-prandial insulin boluses correctly. Despite these behaviours, the algorithm corrected the glucose values in three out of four patients. Only in one case, where fabricated calibrations were too frequent, the automatic system failed to restore the glycemic balance.
Conclusions:
Fabricated calibrations seem to be more important than uncorrected insulin boluses to challenge the HCL systems.
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