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Closed-loop systems improve glycaemic control in inpatients with type 2 diabetes

Devices – January 2019 digest

Impact of a closed-loop system versus subcutaneous insulin on hyperglycaemia in hospitalised patients

Bally L, Thabit H, Hartnell S et al (2018) Closed-loop insulin delivery for glycemic control in noncritical care. N Engl J Med 379: 547–56

  • Hyperglycaemia in hospitalised patients is strongly associated with increased length of hospital stay, higher complication rates and increased risk of mortality.  
  • In this study, researchers from two hospitals in the UK and Switzerland wanted to determine whether a closed-loop system could improve glycaemic control in people with type 2 diabetes who were receiving noncritical care in hospital.
  • Noncritical inpatients requiring subcutaneous insulin were given insulin via a closed-loop system (70 patients) or conventional subcutaneous injections (66 patients) and their glucose levels monitored with sensors. 
  • Blood glucose values were within the target range for a significantly greater period of time in patients using the closed-loop system (65.8%) compared to patients receiving insulin injections (41.4%). 
  • The mean blood glucose level was significantly lower in the closed-loop group versus the insulin injection group (8.5 mmol/L versus 10.4 mmol/L, respectively).   
  • There was no significant difference in the duration of hypoglycaemia or amount of insulin delivered between the groups.
  • Researchers concluded that the use of a closed-loop insulin delivery system among inpatients with type 2 diabetes resulted in significantly better glycaemic control than conventional treatment.

Click here to access the study in full.

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