Hybrid closed-loop systems can help patients with extreme fear of hypoglycemia or hyperglycemia.

Fear of hypoglycemia and hyperglycemia can lead to inappropriate diabetes self-management and untoward health outcomes. We report two patients, representative of these opposite conditions, who benefited from hybrid closed-loop technology. In the patient with fear of hypoglycemia, time in range improved from 26 to 56% and the patient did not present with severe hypoglycemia. Meanwhile, the patient with hyperglycemia aversiveness had a drastic reduction in time below range, from 19 to 4%. We conclude that hybrid closed-loop technology was an effective tool for improvement of glucose values in two patients with fear of hypoglycemia and hyperglycemia aversiveness, respectively.