Australian Study: Smart Insulin Pumps Help Teens With High A1C

Australian Study: Smart Insulin Pumps Help Struggling Teens — But Mental Health Support Still Essential

A study from Australia offers encouraging news for families of teenagers with type 1 diabetes who are having difficulty keeping blood sugar under control. Researchers at the Children's Diabetes Centre, Telethon Kids Institute, University of Western Australia found that advanced hybrid closed-loop (AHCL) insulin pump therapy — often called an "artificial pancreas" system — significantly improved blood sugar levels in high-risk youth, without increasing dangerous low blood sugar events.

What the Researchers Did

The six-month clinical trial enrolled 42 young people with type 1 diabetes (average age 16.2 years) who were already using insulin pumps but still had poor glycemic control. All participants had an A1C above 8.5% — the study group averaged a striking 9.8% A1C at the start. Teens were randomly assigned either to continue their current pump therapy (with or without a continuous glucose monitor) or to switch to an advanced hybrid closed-loop system, which automatically adjusts insulin delivery based on real-time glucose readings.

What They Found

After 24 weeks, teens using the AHCL system showed meaningful improvements across the board:

• A1C dropped from 9.8% to 8.8% in the AHCL group — a nearly 1% reduction — while the control group saw almost no change (9.9% to 9.9%).
• Time in range (70–180 mg/dL) increased by 19.1% — meaning teens spent roughly 4.5 more hours per day with healthy blood sugar levels.
• Time above 180 mg/dL decreased by 17.7%, reflecting significantly less high blood sugar exposure.
• Time below 70 mg/dL did not increase, confirming the technology improved control without adding hypoglycemia risk — a key safety concern for parents and clinicians.

The Mental Health Finding

Despite the impressive glucose improvements, psychosocial outcomes — including diabetes distress, quality of life, anxiety, depression, and fear of low blood sugar — did not differ significantly between the two groups. This is an important reminder that better technology does not automatically reduce the emotional burden of living with diabetes.

Why This Matters for US Patients

In the United States, the American Diabetes Association (ADA) recommends an A1C below 7.5% for most youth with type 1 diabetes — a target many teenagers struggle to reach. The 9.8% average A1C in this study reflects a population commonly seen in American clinics, making these findings directly relevant. Several AHCL systems are already FDA-approved and commercially available in the US, including the Medtronic MiniMed 780G and Tandem t:slim X2 with Control-IQ. However, access remains unequal due to insurance coverage gaps and cost barriers. This Australian research reinforces that US providers should actively pursue AHCL therapy for high-risk teens, while also ensuring robust mental health and diabetes care support is part of the treatment plan — because the emotional weight of diabetes doesn't disappear with better hardware.

If your teenager has an A1C above 8.5% despite using an insulin pump, talking to their endocrinologist about hybrid closed-loop technology may be one of the most impactful conversations you can have this year.

Study Citation

Abraham, Smith, & Dart. Glycemic and Psychosocial Outcomes of Advanced Hybrid Closed-Loop Therapy in Youth With High HbA1c: A Randomized Clinical Trial. Diabetes Care, 2025. DOI: 10.2337/dc24-0276. PMID: 39269686.