Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis

Bally, Lia; Gubler, Philipp; Thabit, Hood; Hartnell, Sara; Ruan, Yue; Wilinska, Malgorzata E.; Evans, Mark; Semmo, Mariam; Vogt, Bruno; Coll, Anthony P.; Stettler, Christoph; Hovorka, Roman

doi:10.1016/j.kint.2019.03.006

Cited by 65 publications

(41 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We aimed to analyze 15 participants with complete data. The primary endpoint was the percentage of time with plasma glucose between 5.6 to 10.0 mmol/L from 07:00 to 17:00 (10 hours), in line with previous studies in adults with type 2 diabetes using the same fully closed‐loop insulin delivery system . Other endpoints are listed in Table S1.…”

Section: Methodsmentioning

confidence: 92%

Short‐term fully closed‐loop insulin delivery using faster insulin aspart compared with standard insulin aspart in type 2 diabetes

Bally

Herzig

Ruan

et al. 2019

Diabetes Obesity Metabolism

Self Cite

View full text Add to dashboard Cite

We evaluated the efficacy and safety of short‐term fully closed‐loop insulin delivery using faster versus standard insulin aspart in type 2 diabetes. Fifteen adults with insulin‐treated type 2 diabetes underwent 22 hours of closed‐loop insulin delivery with either faster or standard insulin aspart in a double‐blind randomized crossover design. Basal‐bolus regimen was replaced by model predictive control algorithm‐directed insulin delivery based on sensor glucose levels. The primary outcome was time with plasma glucose in target range (5.6–10.0 mmol/L) and did not differ between treatments (mean difference [95% CI] 3.3% [−8.2; 1.7], P = 0.17). Mean glucose and glucose variability were comparable, as was time spent below and above target range. Hypoglycaemia (<3.5 mmol/L) occurred once with faster insulin aspart and twice with standard insulin aspart. Mean total insulin dose was higher with faster insulin aspart (mean difference [95% CI] 3.7 U [0.7; 6.8], P = 0.021). No episodes of severe hypoglycaemia or other serious adverse events occurred. In conclusion, short‐term fully closed‐loop in type 2 diabetes may require higher dose of faster insulin aspart compared with standard insulin aspart to achieve comparable glucose control.

show abstract

Section: Methodsmentioning

confidence: 92%

Short‐term fully closed‐loop insulin delivery using faster insulin aspart compared with standard insulin aspart in type 2 diabetes

Bally

Herzig

Ruan

et al. 2019

Diabetes Obesity Metabolism

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several such studies of initiating AID systems in the hospital have been performed in medical or surgical patients as well as in patients on hemodialysis or women in the peripartum/postpartum period. [111][112][113][114][115][116][117][118] In the largest of these studies, 111 Bally et al reported that initiation of AID system technology in the hospital for patients receiving noncritical care achieved a higher percentage of TIR when compared to standard hospital management. The times in range were, respectively, 65.8 (±standard deviation 16.8)% vs 41.5 (±16.9)%, with a difference of 24.3 (±2.9)% (95% CI 18.6-30.0; P < .001).…”

Section: Improved Glycemic Outcomesmentioning

confidence: 99%

Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline

Galindo

Umpiérrez

Rushakoff

et al. 2020

J Diabetes Sci Technol

Self Cite

102

View full text Add to dashboard Cite

This article is the work product of the Continuous Glucose Monitor and Automated Insulin Dosing Systems in the Hospital Consensus Guideline Panel, which was organized by Diabetes Technology Society and met virtually on April 23, 2020. The guideline panel consisted of 24 international experts in the use of continuous glucose monitors (CGMs) and automated insulin dosing (AID) systems representing adult endocrinology, pediatric endocrinology, obstetrics and gynecology, advanced practice nursing, diabetes care and education, clinical chemistry, bioengineering, and product liability law. The panelists reviewed the medical literature pertaining to five topics: (1) continuation of home CGMs after hospitalization, (2) initiation of CGMs in the hospital, (3) continuation of AID systems in the hospital, (4) logistics and hands-on care of hospitalized patients using CGMs and AID systems, and (5) data management of CGMs and AID systems in the hospital. The panelists then developed three types of recommendations for each topic, including clinical practice (to use the technology optimally), research (to improve the safety and effectiveness of the technology), and hospital policies (to build an environment for facilitating use of these devices) for each of the five topics. The panelists voted on 78 proposed recommendations. Based on the panel vote, 77 recommendations were classified as either strong or mild. One recommendation failed to reach consensus. Additional research is needed on CGMs and AID systems in the hospital setting regarding device accuracy, practices for deployment, data management, and achievable outcomes. This guideline is intended to support these technologies for the management of hospitalized patients with diabetes.

show abstract

“…48 A smaller trial with a post-hoc analysis showed increased time in target in the patients on hemodialysis. 49…”

Section: Prevention Of Hypoglycemiamentioning

confidence: 99%

Inpatient Hypoglycemia: The Challenge Remains

Cruz

2020

J Diabetes Sci Technol

View full text Add to dashboard Cite

Hypoglycemia in inpatients with diabetes remains the most common complication of diabetes therapies. Hypoglycemia is independently associated with increased morbidity and mortality, increased length of stay, increased readmission rate, and increased cost. This review describes the importance of reporting and addressing inpatient hypoglycemia; it further summarizes eight strategies that aid clinicians in the prevention of inpatient hypoglycemia: auditing the electronic medical record, formulary restrictions and dose-limiting strategies, hyperkalemia order sets, electronic glucose management systems, prediction tools, diabetes self-management, remote surveillance, and noninsulin medications.

show abstract

Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis

Cited by 65 publications

References 19 publications

Short‐term fully closed‐loop insulin delivery using faster insulin aspart compared with standard insulin aspart in type 2 diabetes

Short‐term fully closed‐loop insulin delivery using faster insulin aspart compared with standard insulin aspart in type 2 diabetes

Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline

Inpatient Hypoglycemia: The Challenge Remains

Contact Info

Product

Resources

About