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Association between comorbidity burden and glycaemic profiles in adults with type 1 diabetes using hybrid closed-loop

Aatif Syed1,2, Akash Konantambigi1,2, Vasant Shenoy1,3

  • 1College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.

Internal Medicine Journal
|May 18, 2026
PubMed

Insights

Comorbidities like obesity and anxiety impact type 1 diabetes management. Higher comorbidity burden in adults using hybrid closed-loop systems correlated with more time below target glucose levels.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Technology

Background:

  • Type 1 diabetes (T1D) management requires continuous glucose monitoring and insulin delivery.
  • Hybrid closed-loop (HCL) systems offer improved glycaemic control for T1D.
  • The impact of comorbidities on HCL system effectiveness in T1D is not fully understood.

Purpose of the Study:

  • To investigate the association between comorbidity burden and glycaemic outcomes in adults with T1D using HCL systems.
  • To identify specific comorbidities that may affect glycaemic control in this population.

Main Methods:

  • Secondary analysis of a multicentre Australian cohort.
  • Inclusion of 158 adults with T1D using HCL systems.
  • Assessment of comorbidity prevalence and its relationship with glycaemic metrics (time in range, time below range, mean glucose).

Main Results:

  • High prevalence of comorbidities including obesity, dyslipidaemia, and anxiety/depression, especially in regional centres.
  • A significant positive correlation was found between higher comorbidity burden and increased time below range (<3 mmol/L).
  • No significant association was observed between comorbidity burden and mean glucose or time in range.

Conclusions:

  • Multimorbidity significantly influences glycaemic stability in adults with T1D using HCL systems.
  • Individualised optimisation of automated insulin delivery therapy is crucial in real-world settings.
  • Further research is needed to address the challenges posed by comorbidities in T1D management with advanced technologies.

Keywords:
continuous glucose monitoringhybrid closed‐loop systemstype 1 diabetes

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