Closed-loop systems-also referred to as artificial pancreas systems-are an advanced technological solution for treating type 1 diabetes. They are composed of three main elements:

• An automated insulin infusion system (insulin pump)

• A continuous glucose monitoring (CGM) sensor

• Various types of algorithms, which regulate insulin delivery predictively and continuously

Thanks to this integration and the algorithm's continuous execution-which determines the insulin dose based on sensor data-these systems enable more stable glucose control, greater time in range (70-180 mg/dL), and a significant reduction in hypoglycemia, especially during the night.

Hybrid closed-loop systems (AHCL)

The patient enters the amount of carbohydrates consumed, and the system automatically adjusts basal insulin and delivers correction boluses according to the algorithm.

Fully automated systems

Not yet approved or available in our region but already used in other countries. They require minimal or no patient intervention and represent the next step toward full automation of insulin infusion.

· Increased time in range, associated with lower risk of complications

· Reduced hypoglycemia, especially during the night

· Less burden of daily self-management: the system adapts to the patient's lifestyle

· Improved HbA1c without increasing hypoglycemia risk

· Greater quality of life and independence

At barnaclínic+, we offer a comprehensive, precise and personalized approach to the diagnosis and treatment of diabetes, regardless of the type. Our team from the Endocrinology and Nutrition Department of Hospital Clínic de Barcelona provides:

What's the difference between an insulin pump and an artificial pancreas?

An insulin pump only delivers insulin, but it doesn't automatically adjust the dose. An artificial pancreas does, thanks to an algorithm and continuous glucose sensor.

---

How does a closed-loop system work?

It delivers basal insulin continuously and provides boluses on demand and/or automatically, based on decisions made by the algorithm using sensor data.

---

Can I use a closed-loop system without a glucose sensor?

No. The sensor is essential for the algorithm to function correctly.

---

What is Omnipod 5 and how does it work?

Omnipod® 5 is an automated insulin delivery system for people with type 1 diabetes. It combines a tubeless insulin Pod, a compatible continuous glucose monitor and an algorithm that automatically adjusts insulin delivery according to changes in glucose levels.

SmartAdjust™ technology is built into the Pod and can increase, decrease or pause insulin delivery every 5 minutes to help move glucose towards the selected target.

---

Is Omnipod 5 a tubeless insulin pump?

Yes. Unlike insulin pumps that deliver insulin through an infusion set connected by tubing, Omnipod 5 uses a Pod worn directly on the body and does not require external tubing. Each Pod can be worn for up to 3 days (72 hours).

This may be particularly appealing to people who are looking for greater freedom of movement or prefer a tubeless insulin delivery system.

---

Which continuous glucose monitors are compatible with Omnipod 5?

Omnipod® 5 is compatible with Dexcom G7® and FreeStyle Libre 2 Plus®. The system receives glucose readings from the sensor and uses this information to automatically adjust insulin delivery.

The choice of continuous glucose monitor and closed-loop system should be made together with a specialist diabetes team, taking into account each patient's clinical needs and preferences.

---

How does the Medtronic MiniMed™ 780G® system work?

MiniMed™ 780G® is an advanced automated insulin delivery system that combines a Medtronic insulin pump, continuous glucose monitoring and the SmartGuard™ algorithm. The system automatically adapts insulin delivery according to glucose readings and their predicted evolution.

One of its key features is its ability to automatically adjust basal insulin delivery and provide automatic correction boluses when needed, with the aim of increasing the amount of time glucose levels remain within the target range.

---

How does Tandem t:slim X2™ with Control-IQ® technology work?

The Tandem t:slim X2™ insulin pump with Control-IQ® technology uses continuous glucose monitoring data to predict changes in glucose levels and automatically adjust insulin delivery.

Based on these predictions, the system can increase, decrease or temporarily stop basal insulin delivery and provide automatic corrections when needed. It also includes specific settings that can adapt its operation to situations such as sleep or physical activity.

---

How does mylife YpsoPump® with CamAPS FX work?

The mylife YpsoPump® with CamAPS FX system combines an insulin pump, continuous glucose monitoring and the CamAPS FX algorithm, which uses sensor glucose readings to automatically adapt insulin delivery to each person's needs.

The algorithm learns and progressively adapts to individual insulin requirements and allows different glucose targets to be set. The system is managed through an app installed on a compatible smartphone, allowing the user to manage different aspects of their insulin therapy.

---

Which closed-loop system is best: MiniMed 780G, Tandem Control-IQ, YpsoPump with CamAPS FX or Omnipod 5?

There is no single closed-loop insulin delivery system that is best for everyone with type 1 diabetes. MiniMed™ 780G®, Tandem t:slim X2™ with Control-IQ®, mylife YpsoPump® with CamAPS FX and Omnipod® 5 use different technologies to automate insulin delivery and have different characteristics in terms of their algorithms, compatible continuous glucose monitors, insulin pumps, connectivity and user experience.

The choice should be individualised, taking into account factors such as insulin requirements, glucose control, physical activity, daily routines, the continuous glucose monitor used, device preferences and previous experience with diabetes technology.

At barnaclínic+, our team specialising in type 1 diabetes and automated insulin delivery systems provides a personalised assessment to help select, configure and monitor the system that is most appropriate for each patient.