Advanced hybrid closed-loop therapy for type 1 diabetes in a correctional facility: a real-world case series.

BACKGROUND: Management of type 1 diabetes (T1D) in correctional facilities is challenging due to limited autonomy, restricted access to technologies, and non-flexible daily routines. OBJECTIVE: To evaluate the feasibility and short-term glycemic outcomes of advanced hybrid closed-loop (aHCL) systems in individuals with T1D in a correctional setting. METHODS: We conducted a retrospective real-world case series including adults with T1D incarcerated in a correctional facility and initiated on an advanced hybrid closed-loop (aHCL) system. Glycemic metrics were assessed at baseline and after 3 months. Continuous variables are reported as median (IQR). Paired comparisons were performed using the Wilcoxon signed-rank test. RESULTS: Six individuals were included and five completed follow-up. Median HbA1c decreased from 9.7% to 7.8% (p = 0.043). Median time in range (TIR) increased from 41% to 49%, while time below range (TBR) and time above range (TAR) decreased from 0.5% to 0% and from 57.5% to 43%, respectively, although these changes were not statistically significant. No severe hypoglycemia or diabetic ketoacidosis events occurred. CONCLUSIONS: Use of aHCL systems in a correctional setting was feasible and associated with improved HbA1c without increased hypoglycemia. These findings support the potential role of advanced diabetes technologies in restricted environments.