Day‐to‐day variability of insulin requirements in the inpatient setting: Observations during fully closed‐loop insulin delivery
Wilinska, Malgorzata E.
Coll, Anthony P.
Blackwell Publishing Ltd
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Boughton, C. K., Daly, A., Thabit, H., Hartnell, S., Herzig, D., Vogt, A., Ruan, Y., et al. (2021). Day‐to‐day variability of insulin requirements in the inpatient setting: Observations during fully closed‐loop insulin delivery. [Other]. https://doi.org/10.1111/dom.14396
Funder: and the Swiss Diabetes Foundation
Abstract: The aim of this study was to characterize the variability of exogenous insulin requirements during fully closed‐loop insulin delivery in hospitalized patients with type 2 diabetes or new‐onset hyperglycaemia, and to determine patient‐related characteristics associated with higher variability of insulin requirements. We retrospectively analysed data from two fully closed‐loop inpatient studies involving adults with type 2 diabetes or new‐onset hyperglycaemia requiring insulin therapy. The coefficient of variation quantified day‐to‐day variability of exogenous insulin requirements during up to 15 days using fully automated closed‐loop insulin delivery. Data from 535 days in 67 participants were analysed. The coefficient of variation of day‐to‐day exogenous insulin requirements was 30% ± 16%, and was higher between nights than between any daytime period (56% ± 29% overnight [11:00 pm to 4:59 am] compared with 41% ± 21% in the morning [5:00 am to 10:59 am], 39% ± 15% in the afternoon [11:00 am to 4:59 pm] and 45% ± 19% during the evening [5:00 pm to 10:59 pm]; all P < 0.01). There is high day‐to‐day variability of exogenous insulin requirements in inpatients, particularly overnight, and diabetes management approaches should account for this variability.
BRIEF REPORT, BRIEF REPORTS, continuous glucose monitoring (CGM), diabetes complications, insulin pump therapy, insulin therapy, observational study, type 2 diabetes
Clinical studies received support from Diabetes UK (#14/0004878)
Swiss National Science Foundation (P1BEP3_165297)
and European Foundation for the Study of Diabetes. Additional support for the Artificial Pancreas work by JDRF, National Institute for Health Research Cambridge Biomedical Research Centre and Wellcome Trust Strategic Award (100574/Z/12/Z)
Abbott Diabetes Care supplied discounted continuous glucose monitoring devices, sensors, and details of communication protocol to facilitate real‐time connectivity. LB received financial support from the University Hospital Bern, University of Bern, Swiss National Science Foundation (P1BEP3_165297)
External DOI: https://doi.org/10.1111/dom.14396
This record's DOI: https://doi.org/10.17863/CAM.69352