Quality of Life and Glycemic Control in Children with Type 1 Diabetes: A Comparative Analysis of Tubed Advanced Hybrid Closed-Loop and Tubeless Conventional Insulin Pump Systems
Amir Babiker, Sara Alfakeeh, Raseel Alsubaie, Farah Alharbi, Sultan Alhammad, Tamam Alshammari, Abeer Al Khalaf, Adel F. Almutairi, Bijesh Yadav, Amal Sabbah, Yara Alqahtani, Haifa AlFaraidi, Fahad Al Juraibah, Angham Al MutairBackground
Type 1 diabetes (T1D) significantly impacts quality of life (QoL) in children and adolescents. Advanced hybrid closed-loop (AHCL) insulin delivery systems have shown improvements in glycemic outcomes, yet comparative data on QoL with tubeless pump systems are limited.
Objective
This study aims to compare glycemic control and QoL between tubed AHCL systems and tubeless open-loop insulin pump systems in pediatric patients with T1D.
Methods
This cross-sectional study was conducted at King Abdullah Specialized Children’s Hospital, Riyadh, from April to June 2026. Participants aged 7 to 17 years with T1D who had been using insulin pump therapy for at least 3 months were included and categorized as tubed AHCL and tubeless pump users. QoL was assessed using the Arabic Pediatric Quality of Life Inventory (PedsQL v3.0 Diabetes Module) through self- and parent proxy reports. Clinical data, including HbA1c and glycemic metrics, were sourced from electronic records.
Results
A total of 148 participants were included, yielding 74 self-reports and 74 parent proxy reports. The tubed AHCL group exhibited significantly better glycemic outcomes, including lower HbA1c, higher time in range, and fewer episodes of severe hypoglycemia (
Conclusion
Tubed AHCL systems were linked to superior glycemic control and higher QoL compared to tubeless pumps. Findings should be interpreted cautiously due to baseline group differences and the cross-sectional design. Prospective studies are needed to confirm causality.