PMID- 36449375
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230322
IS  - 1557-8593 (Electronic)
IS  - 1520-9156 (Print)
IS  - 1520-9156 (Linking)
VI  - 25
IP  - 3
DP  - 2023 Mar
TI  - Fully Closed-Loop Insulin Delivery in Patients Undergoing Pancreatic Surgery.
PG  - 206-211
LID - 10.1089/dia.2022.0400 [doi]
AB  - 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 10.0 mmol/L and 
      more). Over the time of hospitalization, FCL resulted in better glucose control 
      than UC with more time spent in the target range 5.6-10.0 mmol/L (mean [standard 
      deviation] % time in target 77.7% +/- 4.6% and 41.1% +/- 19.5% in FCL vs. UC 
      subjects, respectively; mean difference 36.6% [95% confidence interval 
      18.5-54.8]), without increasing the risk of hypoglycemia. Findings suggest that 
      an adaptive SC FCL approach effectively accommodated the highly variable insulin 
      needs in patients undergoing pancreatic surgery. Clinical trials registration: 
      ClinicalTrials.gov, NCT04361799.
FAU - Krutkyte, Gabija
AU  - Krutkyte G
AD  - Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern 
      University Hospital, University of Bern, Bern, Switzerland.
AD  - Department of Anaesthesiology and Pain Medicine, Bern University Hospital, 
      University of Bern, Bern, Switzerland.
FAU - Roos, Jonathan
AU  - Roos J
AD  - Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern 
      University Hospital, University of Bern, Bern, Switzerland.
FAU - Schuerch, Daniel
AU  - Schuerch D
AD  - Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern 
      University Hospital, University of Bern, Bern, Switzerland.
FAU - Czerlau, Cecilia
AU  - Czerlau C
AD  - Department of Nephrology and Hypertension Inselspital, Bern University Hospital, 
      University of Bern, Bern, Switzerland.
FAU - Wilinska, Malgorzata E
AU  - Wilinska ME
AD  - Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, 
      Cambridge, United Kingdom.
FAU - Wuethrich, Patrick Y
AU  - Wuethrich PY
AD  - Department of Anaesthesiology and Pain Medicine, Bern University Hospital, 
      University of Bern, Bern, Switzerland.
FAU - Herzig, David
AU  - Herzig D
AD  - Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern 
      University Hospital, University of Bern, Bern, Switzerland.
FAU - Hovorka, Roman
AU  - Hovorka R
AD  - Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, 
      Cambridge, United Kingdom.
FAU - Vogt, Andreas P
AU  - Vogt AP
AD  - Department of Anaesthesiology and Pain Medicine, Bern University Hospital, 
      University of Bern, Bern, Switzerland.
FAU - Gloor, Beat
AU  - Gloor B
AD  - Department of Visceral Surgery and Medicine, Bern University Hospital, University 
      of Bern, Bern, Switzerland.
FAU - Bally, Lia
AU  - Bally L
AUID- ORCID: 0000-0003-1993-7672
AD  - Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern 
      University Hospital, University of Bern, Bern, Switzerland.
LA  - eng
SI  - ClinicalTrials.gov/NCT04361799
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20221214
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Insulin)
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin, Regular, Human)
SB  - IM
MH  - Humans
MH  - *Insulin/therapeutic use
MH  - Blood Glucose
MH  - Hypoglycemic Agents/therapeutic use
MH  - Blood Glucose Self-Monitoring
MH  - *Diabetes Mellitus, Type 1/drug therapy
MH  - Insulin Infusion Systems/adverse effects
MH  - Insulin, Regular, Human/therapeutic use
PMC - PMC9983122
OTO - NOTNLM
OT  - Closed-loop glucose control
OT  - Diabetes technology
OT  - Pancreatic surgery
OT  - Perioperative glycemic control
COIS- M.E.W. reports receiving license fees from B. Braun, patents related to 
      closed-loop, and being a consultant at CamDiab Ltd. R.H. reports receiving 
      speaker honoraria from Eli Lilly, Dexcom, and Novo Nordisk; receiving license 
      fees from B. Braun and Medtronic; declares consulting fees from Abbott Diabetes 
      Care; patent issued in closed-loop field (glucose monitoring and control using 
      multimodel approach, patent number CA2702345C) with University of Cambridge and 
      patent issued in closed-loop field (methods for reducing false hypoglycemia alarm 
      occurrence during closed-loop, patent number US9579456B2) with University of 
      Cambridge and Abbott Diabetes Care; being director and stockholder at CamDiab; 
      and leadership/fiduciary role for ATTD. A.P.V. reports advisory board fees from 
      MSD Merck. All other authors declare no competing interests associated with this 
      article.
EDAT- 2022/12/01 06:00
MHDA- 2023/03/04 06:00
PMCR- 2023/02/28
CRDT- 2022/11/30 12:33
PHST- 2022/12/01 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2022/11/30 12:33 [entrez]
PHST- 2023/02/28 00:00 [pmc-release]
AID - 10.1089/dia.2022.0400 [pii]
AID - 10.1089/dia.2022.0400 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2023 Mar;25(3):206-211. doi: 10.1089/dia.2022.0400. Epub 
      2022 Dec 14.