Guidelines of the Polish Society of Pediatric Endocrinology and Diabetology and Pediatric Section of Diabetes Poland on insulin therapy using hybrid closed-loop systems in children and adolescents with diabetes in Poland

List of abbreviations AGP -ambulatory glucose profile PLGS -Predictive Low Glucose Suspend AID -automated insulin delivery PTD -Diabetes Poland APS-DIY -Artificial Pancreas System -Do it YourselfPTEiDD -Polish Society of Pediatric Endocrinology and Diabetology BOHB -beta-hydroxybutyric acid QALY -quality-adjusted life years CGM -continuonus glucose monitoring T1D -type 1 diabetes CSII -continuous subcutaneous insulin infusion rtCGM -real-time CGM HCL -hybrid closed loop SG -sensor glucose ICR -insulin to carb ratio (insulin-to-carbohydrate ratio) TBR -time below range, < 70 mg/dl ISF -insulin sensitivity factor TIR -time in range, 70-180 mg/dl MARD -mean absolute relative difference TITR -time in tight range, 70-140 mg/dl MDI -multiple daily injections Abstract Currently, hybrid closed loop (HCL) systems represent the most advantageous therapeutic option for people with diabetes requiring intensive insulin therapy.They make it possible to achieve optimal metabolic control of the disease in any age group while improving the quality of life of children and adolescents with diabetes and their families.Therefore, we present recommendations for the use of HCL systems in children and adolescents focusing on systems currently available in Poland.These systems should be the first choice in terms of method of insulin therapy in the paediatric population.They can be implemented at any stage of diabetes management.These recommendations are based on scientific evidence and experts' experience.They include principles for the initiation, optimisation, and ongoing management of HCL therapy, as well as the required HCL-related education.