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Closed-loop management of inpatient hyperglycaemia
1Clinical Research Fellow, University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ.
British Journal of Hospital Medicine (London, England : 2005)
|November 12, 2019
Summary
Fully automated insulin delivery, or closed-loop systems, improve inpatient diabetes control, reducing hypoglycemia and hyperglycemia. This technology offers a promising approach for challenging patient groups and may decrease healthcare costs.
Area of Science:
- Endocrinology
- Medical Technology
- Hospital Medicine
Background:
- Rising prevalence of inpatient diabetes necessitates improved glucose management.
- Suboptimal hospital glucose control correlates with increased patient morbidity and mortality.
- Standard insulin therapy presents challenges in achieving target glycemic levels, leading to frequent hypo- and hyperglycemia.
Purpose of the Study:
- To evaluate the efficacy and safety of fully automated insulin delivery (closed-loop) systems in hospitalized patients.
- To compare closed-loop systems against standard insulin therapy for inpatient glucose control.
- To explore the potential of closed-loop systems in complex inpatient populations and their impact on healthcare professionals' workload.
Main Methods:
- Utilized fully automated insulin delivery (closed-loop) systems for inpatient glucose management.
- Compared outcomes with standard insulin therapy protocols.
- Included diverse patient cohorts, such as those on hemodialysis or receiving parenteral/enteral nutrition.
Main Results:
- Closed-loop systems demonstrated safe and superior glucose control compared to standard insulin therapy.
- Effectiveness was observed even in challenging patient populations with complex nutritional support.
- Reduced incidence of both hypoglycemia and hyperglycemia was noted with closed-loop systems.
Conclusions:
- Fully automated insulin delivery systems represent a significant advancement in inpatient diabetes management.
- This technology offers improved glycemic control, particularly for difficult-to-manage patient groups.
- Closed-loop systems have the potential to reduce staff workload and associated healthcare costs.
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