Closed-loop insulin delivery in end-of-life care: a case report.

Boughton, C K; Bally, Lia; Hartnell, S; Wilinska, M; Coll, A P; Evans, M; Stettler, Christoph; Hovorka, R (2019). Closed-loop insulin delivery in end-of-life care: a case report. Diabetic medicine, 36(12), pp. 1711-1714. Wiley 10.1111/dme.13974

[img]
Preview
Text
Boughton_et_al-2019-Diabetic_Medicine (1).pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (479kB) | Preview

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 hospitalized individual whose glucose was managed with closed-loop insulin delivery within a randomized controlled trial setting during a period of terminal illness. During the time in which closed-loop insulin delivery was used, glucose control was safe, with no glucose-related harm. The mean ± sd sensor glucose for this individual was 11.3 ± 4.3 mmol/l, percentage of time spent in target glucose range between 6 and 15 mmol/l was 70.5%, time spent in hypoglycaemia was 2.0% and time spent in significant hyperglycaemia >20 mmol/l was 2.6%. CONCLUSION Closed-loop systems can accommodate personalized 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.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Bally, Lia Claudia and Stettler, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0742-3071

Publisher:

Wiley

Language:

English

Submitter:

Regula Maria Schneider

Date Deposited:

23 Jan 2020 14:22

Last Modified:

26 Jan 2020 06:22

Publisher DOI:

10.1111/dme.13974

PubMed ID:

31002426

BORIS DOI:

10.7892/boris.138361

URI:

https://boris.unibe.ch/id/eprint/138361

Actions (login required)

Edit item Edit item
Provide Feedback