Introduction
T1D, diabetes late complications, DH) hybrid closed-loop systems, hypoglycemia
HYPOGLYCEMIA, TYPE 1 DIABETES
People with type 1 diabetes (T1D) are advised to aim for near-normal blood glucose levels to reduce the risk of diabetes late complications (The most advanced commercially available technology is a single-hormone (SH) closed-loop system, also known as an artificial pancreas (AP). These systems automatically adjust insulin pump delivery based on real-time values from a continuous glucose monitor (CGM). Relative to insulin pump and CGM systems without automated insulin dosing, APs have been shown to improve glucose control (A potential means of reducing the risk of hypoglycemia using closed-loop systems is to add the glucose-elevating hormone glucagon. Such dual-hormone (DH) hybrid closed-loop systems are not currently commercially available but have generated interest in research trials investigating their performance relative to SH systems. A meta-analysis found that both SH and DH closed-loop systems resulted in more time spent in the target glucose range (TIR [3.9-10.0 mmol/L]) compared to non-automated delivery systems. Furthermore, DH was superior to SH in increasing TIR and decreasing time below range (TBR [< 3.9 mmol/L]) (Our group has developed the DiaCon AP (The aim of this study was therefore to test our hypothesis, that the updated DiaCon AP DH configuration would be safe and effective to use in individuals with T1D between 13-17 years old and that it would be 