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Do hybrid closed-loop systems benefit T1D management?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My 18-year-old son has type 1 diabetes and recently started using a hybrid closed-loop system. While his overall HbA1c has improved, he occasionally experiences unexplained blood sugar spikes after meals, even when we carefully count his carbohydrates. Could this indicate that his pump settings need adjustment, or should we consider other potential factors like stress or exercise? We also wonder if we should revisit his basal and bolus ratios as he continues to grow. Is there a general guideline for teenagers using advanced systems like this?

Please advise.

Answered by Dr. Srinivasa Murthy

Education:

MBBS

Professional Bio:

Dr. Srinivasa, with extensive 17 experience in diabetes reversal, weight management, and hormone-related conditions, takes a holistic, patient-centric approach. He specializes in lifestyle modifications and personalized nutrition, using evidence-based medicine to treat diseases at their root. His methods help patients achieve lasting health while reducing or eliminating medications.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I am sorry to hear about your son's challenges.

Unexplained blood sugar spikes could indicate that his pump settings, especially basal and bolus ratios need adjustment. Teenagers often experience fluctuations in insulin needs due to growth, hormones, stress, or exercise. Regularly reviewing and adjusting his insulin settings is essential as his body changes.

Guidelines for teenagers:

  1. Regular monitoring: Analyze CGM (continuous glucose monitor) data to optimize insulin settings.
  2. Adjustments: Modify basal rates and carbohydrate-to-insulin ratios as needed.
  3. Consider key factors: Account for stress, exercise, and hormonal changes.

Consulting with his healthcare team can help fine-tune his management plan. You are doing a great job supporting him through this!

If you would like more detailed information or have other questions, please feel free to book a consultation with me.

Thank you.

Medically reviewed by iCliniq medical review team
Published At April 13, 2025
Reviewed At April 13, 2025

Education:

MBBS

Professional Bio:

Dr. Srinivasa, with extensive 17 experience in diabetes reversal, weight management, and hormone-related conditions, takes a holistic, patient-centric approach. He specializes in lifestyle modifications and personalized nutrition, using evidence-based medicine to treat diseases at their root. His methods help patients achieve lasting health while reducing or eliminating medications.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Srinivasa, with extensive 17 experience in diabetes reversal, weight management, and hormone-related conditions, takes a holistic, patient-centric approach. He specializes in lifestyle modifications and personalized nutrition, using evidence-based medicine to treat diseases at their root. His methods help patients achieve lasting health while reducing or eliminating medications.

This doctor is not available for online consultations on the platform anymore.

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