Perioperative Considerations for Evolving Artificial Pancreas Devices

Area of Science:

• Endocrinology
• Medical Devices
• Anesthesiology

Background:

• Type 1 diabetes mellitus (T1DM) management requires intensive patient self-care for glycemic control.
• Challenges include insulin pharmacokinetics variability and external factors impacting glucose levels.
• Current treatment necessitates frequent glucose monitoring and insulin dosing.

Purpose of the Study:

• To provide an overview of closed-loop artificial pancreas devices (C-APDs).
• To propose a strategy for studying the intraoperative use of C-APDs.
• To highlight the potential of C-APDs in enhancing intraoperative glycemic control.

Main Methods:

• Review of C-APD technology, including continuous glucose monitors, algorithms, and insulin delivery systems.
• Analysis of existing data on the MiniMed 670G system's efficacy and safety.
• Discussion of limited case reports on intraoperative C-APD use.

Main Results:

• C-APDs automate glycemic management, improving control and reducing hypoglycemia.
• The MiniMed 670G system shows promise in enhancing glycemic control with less patient self-management.
• Limited data suggest potential for safe intraoperative C-APD use.

Conclusions:

• C-APDs are expected to see increased adoption in diabetes management.
• Further research and protocol development are needed for safe intraoperative C-APD application.
• Anesthesiologists must familiarize themselves with C-APD technology for improved patient safety.