Fully closed-loop insulin delivery in patients undergoing pancreatic surgery.

Krutkyte, Gabija; Roos, Jonathan; Schuerch, Daniel; Czerlau, Cecilia; Wilinska, Malgorzata; Wüthrich, Patrick; Herzig, David; Hovorka, Roman; Vogt, Andreas; Gloor, Beat; Bally, Lia (2023). Fully closed-loop insulin delivery in patients undergoing pancreatic surgery. Diabetes technology & therapeutics, 25(3), pp. 206-211. Mary Ann Liebert 10.1089/dia.2022.0400

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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 10.0mmol/L and more). Over the time of hospitalisation, FCL resulted in better glucose control than UC with more time spent in the target range 5.6-10.0mmol/L (mean (SD) % time in target 77.7±4.6 % and 41.1±19.5 % in FCL vs. UC subjects, respectively; mean difference 36.6 % (95% CI [18.5; 54.8])), without increasing the risk of hypoglycaemia. Findings suggest that an adaptive SC FCL approach effectively accommodated the highly variable insulin needs in patients undergoing pancreatic surgery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Krutkyte, Gabija, Czerlau, Cecilia, Wüthrich, Patrick Yves, Herzig, David, Vogt, Andreas, Gloor, Beat, Bally, Lia Claudia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1520-9156

Publisher:

Mary Ann Liebert

Language:

English

Submitter:

Pubmed Import

Date Deposited:

01 Dec 2022 10:44

Last Modified:

06 Apr 2023 09:07

Publisher DOI:

10.1089/dia.2022.0400

PubMed ID:

36449375

BORIS DOI:

10.48350/175369

URI:

https://boris.unibe.ch/id/eprint/175369

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