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Fully Closed-Loop Insulin Delivery in Patients Undergoing Pancreatic Surgery.

Published version
Peer-reviewed

Type

Article

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Authors

Krutkyte, Gabija 
Roos, Jonathan 
Schuerch, Daniel 
Czerlau, Cecilia 
Wilinska, Malgorzata E 

Abstract

The central role of pancreas in glucose regulation imposes high demands on perioperative glucose management in patients undergoing pancreatic surgery. In a post hoc subgroup analysis of a randomized controlled trial, we evaluated the perioperative use of subcutaneous (SC) fully closed-loop (FCL; CamAPS HX) versus usual care (UC) insulin therapy in patients undergoing partial or total pancreatic resection. Glucose control was compared using continuous glucose monitoring (CGM) metrics (% time with CGM values between 5.6 and 10.0 mmol/L and more). Over the time of hospitalization, FCL resulted in better glucose control than UC with more time spent in the target range 5.6-10.0 mmol/L (mean [standard deviation] % time in target 77.7% ± 4.6% and 41.1% ± 19.5% in FCL vs. UC subjects, respectively; mean difference 36.6% [95% confidence interval 18.5-54.8]), without increasing the risk of hypoglycemia. Findings suggest that an adaptive SC FCL approach effectively accommodated the highly variable insulin needs in patients undergoing pancreatic surgery. Clinical trials registration: ClinicalTrials.gov, NCT04361799.

Description

Keywords

Closed-loop glucose control, Diabetes technology, Pancreatic surgery, Perioperative glycemic control, Humans, Insulin, Blood Glucose, Hypoglycemic Agents, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 1, Insulin Infusion Systems, Insulin, Regular, Human

Journal Title

Diabetes Technol Ther

Conference Name

Journal ISSN

1520-9156
1557-8593

Volume Title

Publisher

Mary Ann Liebert Inc