Closed-loop insulin delivery in end-of-life care: a case report.
Diabetic medicine : a journal of the British Diabetic Association
Blackwell Publishing Inc.
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Boughton, C., Bally, L., Hartnell, S., Wilinska, M., Coll, A., Evans, M., Stettler, C., & et al. (2019). Closed-loop insulin delivery in end-of-life care: a case report.. Diabetic medicine : a journal of the British Diabetic Association, 36 (12), 1711-1714. https://doi.org/10.1111/dme.13974
Background Glucose management for people with diabetes approaching the end of life can be very challenging. The aim is to balance a minimally invasive approach with avoidance of symptomatic hypo- and hyperglycaemia. Case Report We present a case of a hospitalised patient whose glucose was managed with closed-loop insulin delivery within a randomised controlled trial setting during a period of terminal illness. During the time using closed-loop, glucose control was safe with no glucose-related harm. Mean sensor glucose was 11.3 ± 4.3mmol/L (mean ± SD), percentage of time spent in target glucose range between 6 and 15 mmol/l was 70.5%, time in hypoglycaemia was 2.0% and time in significant hyperglycaemia >20 mmol/l was 2.6%. Discussion Closed-loop systems can accommodate personalised glucose targets and highly variable insulin requirements. Factory-calibrated continuous glucose sensors and insulin pump therapy are less intrusive than finger-stick glucose measurements and insulin injections respectively. Closed-loop systems may provide a safer and less burdensome approach to glucose management towards the end of life.
Humans, Diabetes Mellitus, Type 2, Insulin, Blood Glucose, Insulin Infusion Systems, Terminal Care, Fatal Outcome, Female
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Diabetes UK (14/0004878)
Wellcome Trust (100574/Z/12/Z)
External DOI: https://doi.org/10.1111/dme.13974
This record's URL: https://www.repository.cam.ac.uk/handle/1810/291080
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