Starting Strong: Setting Up myLoop in Very Young Children
“myLoop managed to maintain a good time in range without increasing time spent below range.” – Prof. Sabine Hofer
The webinar “Starting Strong: myLoop powered by CamAPS FX – Setup and Optimisation in Very Young Children,” featuring Prof. Sabine Hofer, explored the challenges of managing diabetes in toddlers and preschoolers. While no small task, the session showed how, with the right technology, personalized care, and support, effective diabetes management in this sensitive age group is entirely achievable and can be approached with confidence.Watch the full recording now on-demand and benefit from expert guidance on supporting your patients with exercise management in AID therapy.
Starting Strong: Setting Up myLoop in Very Young Children
Webinar Recap - June 16, 2025
Managing diabetes in toddlers and preschoolers is no small task, but with the right technology, personalized care, and support, it can be done with confidence.
In our exclusive webinar, "Starting Strong: myLoop powered by CamAPS FX – Setup and Optimization in Very Young Children," we welcomed pediatric diabetes expert Professor Sabine E. Hofer for an inspiring and practical session on how early adoption of AID (Automated Insulin Delivery) therapy can transform care in this sensitive age group.
What We Learned
Better Glucose Control from the Start
Early use of myLoop helps stabilize blood glucose levels in very young children, improving time-in-range without increasing the risk of lows.
Personalized Tools for Individual Needs
Features like Personal Glucose Target, "Ease-Off", "Boost", and "Add Meal" allow care teams to tailor therapy to each child's unique rhythm and needs. Also there are remote monitoring options available with companion app, SMS messages and automatic data sharing.
The Power of Preparation
Successful onboarding starts with clear, compassionate education—for parents, caregivers, and nursery staff alike. Training builds trust and ensures smoother day-to-day management.
Real Stories, Real Results
Case studies highlighted real-world success in managing diabetes onset in toddlers, with improved outcomes and empowered families.
Key Quotes
“The system managed to maintain a good time in range without increasing time spent below range.”
“Education and training of team members and nursery staff are crucial for successful application."
Why It Matters
This session reminded us that with the right system and support, even the youngest children with diabetes can thrive. It’s about building confidence, for families and care teams and laying a strong foundation from the very beginning.
If you couldn’t join us live, you can now catch up at your convenience.
Questions asked:
Is it recommended to record each hypoglycemia treatment event within the app for optimal algorithm performance? Could the omission of hypoglycemia treatment entries increase the risk of subsequent hypoglycemic episodes, potentially due to the algorithm overcorrecting perceived hyperglycemia?
Ideally, all hypoglycemic events should be entered into the system.
This not only informs the algorithm and contributes to its learning, but also helps it adopt a gentler approach during the post-hypoglycemia period. Missing an entry will not increase the likelihood of experiencing more lows throughout the day.
Whenever possible, the amount of carbohydrates used to treat the hypoglycemia should be reduced to half of the usual dose typically given in the absence of AID.
What is the recommended duration for the algorithm's learning phase to achieve stable and individualized insulin delivery?
After a few days the system can identify some patterns and TDD, but we usually ask to let the system learn for 2 to 3 weeks.
In cases where a child continues to experience nocturnal hypoglycemia despite multiple adjustments to the Personal Glucose Target (PGT), what strategies or settings would you recommend?
Nocturnal hypoglycemia is primarily caused by an excessive amount of Insulin on Board (IoB). This is often the consequence of behaviours leading to evening hyperglycemia. Ideally, addressing and managing evening hyperglycemia helps to prevent hypoglycemia during the night.
As a first step, it is important to check the use of the “Add Meal” and “Slowly Absorbed Meal”, to ensure it is not being used incorrectly. Misuse of this function can lead the algorithm to exert a strong corrective effort to bring glucose levels back within range, resulting in a high level of active insulin.
It is also advisable to verify that the insulin-to-carbohydrate ratio is not set too low, as this can similarly trigger an intense response from the algorithm and lead to increased IoB.
Once these two parameters have been reviewed and adjusted, if necessary, it is important to check the Personal Glucose Target (PGT), which may be set too high. Tightening (i.e. lowering) the PGT, as clinically appropriate, can help manage evening glucose excursions more effectively. In young children, the target should not be set below 5 mmol/L during the evening and early part of the night.
After midnight and for the remainder of the night, it is recommended to raise the PGT by 0.5 to 1 mmol/L compared to the pre-midnight target. This helps to balance the need for safety with effective glucose control.
The target should be lowered step by step, allowing time to observe the effects and achieve the desired outcome.
You can find this information and more in “Optimizing the mylife Loop AID system, powered by mylife CamAPS FX algorithm – Recommendations for clinical practice”
How can persistent postprandial hyperglycemia be effectively managed when increasing the bolus dose or extending the bolus-to-meal interval leads to subsequent hypoglycemia?
ISPAD explains that very young children often require proportionally larger bolus doses than older children, typically accounting for 60 to 80% of the total daily dose (TDD). This makes accurate carbohydrate counting, precise bolus dosing and timing, and close attention to the quality and quantity of carbohydrates crucial components of the child’s daily routine.
Moreover, the very nature of the meal itself is an important factor to consider. If a meal is unusually high in fat or protein, as well as in carbohydrates, especially those with a low glycemic index (e.g., takeaway pizza), and glycemic control cannot be achieved with a bolus alone (despite an appropriate ICR for the relevant time slot), then the use of “Add Meal” and “Slowly Absorbed Meal” function may be appropriate.
Recommended Approach:
Pre-meal bolus: Deliver a bolus covering part of the carbohydrate content 10 to 15 minutes before the meal
Remaining carbohydrates: Enter the rest of the carbohydrates using the “Add Meal” and “Slowly Absorbed Meal”.
A practical starting point is a 60% bolus / 40% “Add Meal” and “Slowly Absorbed Meal” split, to be adjusted based on the individual’s glycemic response.
Important Note:
The “Add Meal” and “Slowly Absorbed Meal” should never be used as a standalone. Always pair it with a pre-meal bolus to achieve optimal postprandial glucose control.
This feature is often overused for meals that could be more effectively managed with a well-timed, full bolus, particularly when meal composition does not justify the need for extended absorption considerations. Use this function only when a bolus alone, given 10 to 15 minutes before the meal, is not sufficient and when the settings have been confirmed as appropriate. It is also advisable to verify that the insulin-to-carbohydrate ratio is not set too low, as this can similarly trigger an intense response from the algorithm and lead to increased IoB.
You can find this information and more in “Optimizing the mylife Loop AID system, powered by mylife CamAPS FX algorithm – Recommendations for clinical practice”, or the brochure for caregivers “mylife Loop powered by mylife CamAPS FX in very young children with type 1 diabetes – How to optimize the system.”