The world of type one diabetes mellitus and insulin therapy, pumps, blood sugar monitoring and glycaemic control is fast-growing. Assessing control is no longer simply measuring HbA1C. It’s very hard to keep up with the technology. The possible advantage of hybrid closed-loop therapy (an artificial pancreas) over sensor-augmented pump therapy in very young children with type one diabetes is unclear. Ware J et al (N Engl J Med 2022;386:209–219) have conducted a multicentre, randomised, crossover trial, in children with type one diabetes who were receiving insulin-pump therapy at seven centres across Austria, Germany, Luxembourg, and the UK. …