A Closed loop system (also Automated insulin delivery, AID) is currently (March 2026) the most advanced form of insulin therapy. It connects an insulin pump directly to a CGM sensor and largely automatically adapts insulin delivery to the current glucose profile - the best technical approach to date to an “artificial pancreas”.
How it works
The system consists of three components:
- CGM sensor: continuously measures glucose
- Algorithm: calculates insulin requirements in real time
- Insulin pump: delivers basal and corrective insulin automatically
With current Hybrid closed-loop systems The technology regulates the basal rate and corrections independently. The user only enters the meal boluses manually.
Advantages
- Significantly more time in the target area (Time in Range)
- Great reduction of severe hypoglycemia
- Fewer nighttime hypoglycaemia
- Significant relief in everyday life and less diabetes burnout
Current systems (as of 2026)
| system | Special feature |
|---|---|
| Tandem t:slim X2 (Control-IQ) | Automatic correction boluses |
| Medtronic MiniMed 780G | Very good night regulation |
| Omnipod 5 | Tubeless pod system |
| CamAPS FX | App-based and interoperable |
Indications
Closed loop systems are particularly recommended for:
- Unstable blood sugar despite intensive therapy
- Frequent or severe hypoglycemia
- Hypoglycemia unawareness disorder
- Children and adolescents with diabetes
- Pregnancy with diabetes
Further information:
→ Diabetes mellitus – knowledge and overview
→ Why hyporest
→ Continuous glucose monitoring (CGM)
Sources
- German Diabetes Society (DDG). S3 guidelines “Technological aids”. As of 2025. Available at: www.deutsche-diabetes-gesellschaft.de/leitlinien.
- American Diabetes Association. Standards of Medical Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). Available at: diabetesjournals.org.
- Robert Koch Institute (RKI). Federal health reporting – diabetes mellitus in Germany. Berlin 2024.
- International Diabetes Federation (IDF). IDF Diabetes Atlas. 11th edition. Brussels 2025. Available at: diabetesatlas.org.
Important note:
The information in this encyclopedia article is intended solely for general and non-binding information. They do not replace medical advice, diagnosis or therapy. If you have any health questions or complaints, please always consult a doctor or qualified healthcare professional. The content was created with the greatest possible care, but errors cannot be completely ruled out.
Last updated: February 26, 2026
