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.
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024