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Closed-loop management of inpatient hyperglycaemia.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Boughton, CK 

Abstract

The prevalence of diabetes in the inpatient setting is increasing, and suboptimal glucose control in hospital is associated with increased morbidity and mortality. Attaining the recommended glucose levels is challenging with standard insulin therapy. Hypoglycaemia and hyperglycaemia are common and diabetes management in hospital can be a considerable workload burden for health-care professionals. Fully automated insulin delivery (closed-loop) has been shown to be safe, and achieves superior glucose control than standard insulin therapy in the hospital, including in those patients receiving haemodialysis and enteral or parenteral nutrition where glucose control can be particularly challenging. Evidence that the improved glucose control achieved using closed-loop systems can translate into improved clinical outcomes for patients is key to support widespread adoption of this technology. The closed-loop approach has the potential to provide a paradigm shift in the management of inpatient diabetes, particularly in the most challenging inpatient populations, and may reduce staff work burden and the health-care costs associated with inpatient diabetes.

Description

Keywords

Adult, Child, Critical Care, Diabetes Mellitus, Type 1, Enteral Nutrition, Equipment Design, Hospitalization, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Parenteral Nutrition, Patient Satisfaction, Renal Dialysis, Terminal Care

Journal Title

Br J Hosp Med (Lond)

Conference Name

Journal ISSN

1750-8460
1759-7390

Volume Title

80

Publisher

Mark Allen Group

Rights

All rights reserved