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Cambridge hybrid closed-loop use in very young children with type 1 diabetes: Parental expectancies during long-term

Alexia Vidou1, Ineke M Pit-Ten Cate2, Fiona M Campbell3

  • 1Institute of Education and Society, University of Luxembourg, Esch-Belval, Grand Duchy, Luxembourg.

Diabetic Medicine : a Journal of the British Diabetic Association
|July 1, 2026
PubMed

Insights

Extended use of automated insulin delivery (AID) systems like CamAPS FX hybrid closed-loop (HCL) in young children with type 1 diabetes (T1D) sustains glycemic benefits. Parental expectations and trust in AID significantly increase with prolonged real-world experience.

Area of Science:

  • Pediatric Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Type 1 diabetes (T1D) management in very young children presents unique challenges.
  • Automated Insulin Delivery (AID) systems, including hybrid closed-loop (HCL) technology, offer potential improvements in glycemic control.
  • Understanding parental perceptions and expectations is crucial for the successful adoption of AID systems.

Purpose of the Study:

  • To evaluate parental expectancies of AID systems during extended home use of CamAPS FX HCL in very young children with T1D.
  • To assess the impact of prolonged HCL use on parental perceptions and trust in AID technology.
  • To correlate glycemic outcomes with parental expectancies over time.

Main Methods:

  • A multinational randomized crossover trial followed by an 18-month HCL extension phase involving 64 children (aged 1-7) with T1D.
  • Glycemic outcomes (HbA1c) were monitored throughout the study.
  • Parental expectancies were assessed using the INSPIRE questionnaire at baseline, during the trial, and post-extension.

Main Results:

  • HCL use significantly improved HbA1c during the clinical trial and these benefits were sustained over 18 months of home use.
  • Parental expectancies did not change during the clinical trial phase but increased significantly after 18 months of home HCL use.
  • A strong positive correlation was observed between sustained real-world HCL use and increased parental expectancies.

Conclusions:

  • Prolonged use of HCL systems in young children with T1D leads to sustained glycemic control.
  • Parental trust and positive expectancies regarding AID systems grow with extended real-world experience.
  • Experience-dependent adaptation, driven by consistent glycemic outcomes and prolonged use, fosters parental engagement with AID technology.
Abstract

Keywords:
automated insulin deliveryhybrid closed‐loopparental expectanciespsychological impacttype 1 diabetesyoung children

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