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Demographic, medical and psychiatric information, acute diabetes complication rates, two\u2010item diabetes distress scale (DDS2) scores and sensor glucometrics (time in range; TIR) were extracted from electronic health records and diabetes technology platforms.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1827 adults with type 1 diabetes, 226 had comorbid depressive and\/or anxiety disorders [163 female\/63 male; age 38 (IQR: 29.0\u201351.3) years, 23 (15\u201333.3) years diabetes duration]; 196 had depression and 119 had anxiety disorders. HCL\u2010users (\n n<\/jats:italic>\n \u2009=\u2009108; 89 female\/19 male) had lower glycated haemoglobin A\n 1c<\/jats:sub>\n (HbA\n 1c<\/jats:sub>\n ) and higher TIR [HbA\n 1c<\/jats:sub>\n 60.0\u2009mmol\/mol (7.6%) (53.0\u201366.0\/7.0\u20138.2) vs. 73.0\u2009mmol\/mol (8.8%) (58.5\u201385.5\/7.5\u201310.0),\n p<\/jats:italic>\n \u2009<\u20090.001; TIR 63.5 (55.8\u201375.0) vs. 42.0 (23.0\u201355.3),\n p<\/jats:italic>\n \u2009<\u20090.001] than non\u2010HCL users (\n n<\/jats:italic>\n \u2009=\u2009118, 44 female\/74 male) at last follow\u2010up compared to baseline. Glycaemia improved post HCL\u2010initiation compared to pre\u2010HCL [HbA\n 1c<\/jats:sub>\n 60.0\u2009mmol\/mol (7.6%) (53.0\u201366.0\/7.0\u20138.2) vs. 67.5\u2009mmol\/mol (8.3%) (58.8\u201377.8\/7.5\u20139.3),\n p<\/jats:italic>\n \u2009<\u20090.001; TIR 63.5 (55.8\u201375.0) vs. 39.0 (28.0\u201355.8),\n p<\/jats:italic>\n \u2009<\u20090.001]. Severe hypoglycaemia rates did not vary (\n p<\/jats:italic>\n \u2009=\u20090.380), but fewer HCL users experienced ketoacidosis (\n p<\/jats:italic>\n \u2009<\u20090.001). DDS2 scores were lower post\u2010HCL (\n p<\/jats:italic>\n \u2009=\u20090.004) but not when comparing HCL and non\u2010HCL users (\n p<\/jats:italic>\n \u2009=\u20090.230).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HCL users demonstrated improved HbA\n 1c<\/jats:sub>\n and TIR, compared with non\u2010HCL users. These real\u2010world data support safe use of HCL in people with type 1 diabetes and depression\/anxiety in a multidisciplinary setting. Qualitative studies and prospective trials are required to further evaluate the impact of HCL on biomedical and mental health outcomes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.70432","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T02:54:11Z","timestamp":1768964051000},"page":"2362-2373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes of adults with type 1 diabetes and comorbid depression and\/or anxiety disorders using hybrid closed\u2010loop: A retrospective study from a multidisciplinary tertiary centre"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1965-0951","authenticated-orcid":false,"given":"Jonathan","family":"Croos","sequence":"first","affiliation":[{"name":"Department of Diabetes, Faculty of Life Sciences and Medicine King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4373-396X","authenticated-orcid":false,"given":"Adam Kia","family":"Shooshtarian","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Faculty of Life Sciences and Medicine King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Stotesbury","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldine","family":"Gallen","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6084-449X","authenticated-orcid":false,"given":"Khalida","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"},{"name":"Psychiatry Research Group, Department of Psychological Medicine, Diabetes, and Psychology King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yee","family":"Cheah","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilia","family":"Calcia","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaylee","family":"Lovie","sequence":"additional","affiliation":[{"name":"Department of Diabetes King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anusha","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Faculty of Life Sciences and Medicine King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aakanksha","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Faculty of Life Sciences and Medicine King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4013-6810","authenticated-orcid":false,"given":"Rachael J. 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