Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis.
- Bally L Department of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
- Gubler P Department of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Thabit H Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Manchester University Hospitals NHS Foundation, Manchester Academic Health Science Centre, Manchester, UK; Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- Hartnell S Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- Ruan Y Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.
- Wilinska ME Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK.
- Evans ML Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- Semmo M Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Vogt B Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Coll AP Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- Stettler C Department of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Hovorka R Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK. Electronic address: rh347@cam.ac.uk.
- 2019-05-29
Published in:
- Kidney international. - 2019
artificial pancreas
closed-loop insulin delivery
glucose control
hemodialysis
Aged
Aged, 80 and over
Blood Glucose
Diabetes Mellitus, Type 2
Drug Therapy, Computer-Assisted
Female
Hospitalization
Humans
Hypoglycemic Agents
Infusion Pumps, Implantable
Insulin Aspart
Insulin Infusion Systems
Insulin Lispro
Kidney Failure, Chronic
Male
Middle Aged
Monitoring, Physiologic
Renal Dialysis
Treatment Outcome
English
Inpatient diabetes management of those on hemodialysis poses a major challenge. In a post hoc analysis of a randomized controlled clinical trial, we compared the efficacy of fully automated closed-loop insulin delivery vs. usual care in patients undergoing hemodialysis while in hospital. Compared to control patients receiving conventional subcutaneous insulin therapy, those patients receiving closed-loop insulin delivery significantly increased the proportion of time when a continuous glucose monitor was in the target range of 5.6-10.0 mmol/l by 37.6 percent without increasing the risk of hypoglycemia. Thus, closed-loop insulin delivery offers a novel way to achieve effective and safe glucose control in this vulnerable patient population.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
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- DOI 10.1016/j.kint.2019.03.006
- PMID 31133457
- Persistent URL
- https://sonar.ch/global/documents/190731
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