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dc.contributor.authorBoughton, Charlotteen
dc.contributor.authorBally, Len
dc.contributor.authorHartnell, Sen
dc.contributor.authorWilinska, Malgorzataen
dc.contributor.authorColl, Anthonyen
dc.contributor.authorEvans, Marken
dc.contributor.authorStettler, Cen
dc.contributor.authorHovorka, Romanen
dc.date.accessioned2019-04-03T23:30:23Z
dc.date.available2019-04-03T23:30:23Z
dc.date.issued2019-12en
dc.identifier.issn0742-3071
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/291080
dc.description.abstractBackground 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.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherBlackwell Publishing Inc.
dc.rightsAll rights reserved
dc.rights.uri
dc.subjectHumansen
dc.subjectDiabetes Mellitus, Type 2en
dc.subjectInsulinen
dc.subjectBlood Glucoseen
dc.subjectInsulin Infusion Systemsen
dc.subjectTerminal Careen
dc.subjectFatal Outcomeen
dc.subjectFemaleen
dc.titleClosed-loop insulin delivery in end-of-life care: a case report.en
dc.typeArticle
prism.endingPage1714
prism.issueIdentifier12en
prism.publicationDate2019en
prism.publicationNameDiabetic medicine : a journal of the British Diabetic Associationen
prism.startingPage1711
prism.volume36en
dc.identifier.doi10.17863/CAM.38261
dcterms.dateAccepted2019-04-16en
rioxxterms.versionofrecord10.1111/dme.13974en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-12en
dc.contributor.orcidBoughton, Charlotte [0000-0003-3272-9544]
dc.contributor.orcidWilinska, Malgorzata [0000-0003-2739-1753]
dc.contributor.orcidColl, Anthony [0000-0003-2594-7463]
dc.contributor.orcidEvans, Mark [0000-0001-8122-8987]
dc.contributor.orcidHovorka, Roman [0000-0003-2901-461X]
dc.identifier.eissn1464-5491
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
pubs.funder-project-idDiabetes UK (14/0004878)
pubs.funder-project-idWellcome Trust (100574/Z/12/Z)
cam.orpheus.successThu Jan 30 10:49:08 GMT 2020 - Embargo updated*
rioxxterms.freetoread.startdate2020-12-31


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