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.
Vinod Patel highlights the growing evidence base that lifestyle interventions are effective, and encourages persistence even though they can be difficult.
25 May 2023