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Hybrid closed loop systems are being hailed as the greatest advance in type 1 diabetes care since the discovery of insulin. The UK is leading the way with new NICE guidance, but there is work to do to avoid a postcode lottery, writes Gareth Iacobucci “People say it’s the closest thing to living without diabetes. They just feel so relieved at having to think about their condition much less. It’s absolutely amazing.” Consultant diabetologist Emma Wilmot has seen major advances in the management of type 1 diabetes over the past 20 years, including the advent of insulin pumps and continuous glucose monitoring (CGM) sensors that attach to the skin. Hybrid closed loop systems also known as “artificial pancreas” systems combine both these elements to create an automated system of basal (long acting) insulin delivery that is being hailed as the most significant advancement in type 1 diabetes care since the discovery of insulin over 100 years ago. Now, in its final guidance for

United kingdomGareth iacobucciEmma wilmotNational institute for healthAssociation of british clinical diabetologistsNational instituteCare excellenceBritish clinical diabetologists