Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis

Lia Bally; Philipp Gubler; Hood Thabit; Sara Hartnell; Yue Ruan; Malgorzata E Wilinska; Mark L Evans; Mariam Semmo; Bruno Vogt; Anthony P Coll; Christoph Stettler; Roman Hovorka

doi:10.1016/j.kint.2019.03.006

Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis

Lia Bally, Philipp Gubler, Hood Thabit, Sara Hartnell, Yue Ruan, Malgorzata E Wilinska, Mark L Evans, Mariam Semmo, Bruno Vogt, Anthony P Coll, Christoph Stettler, Roman Hovorka

Division of Diabetes, Endocrinology & Gastroenterology (L5)

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Pages (from-to)	593-596
Number of pages	4
Journal	Kidney International
Volume	96
Issue number	3
Early online date	20 Mar 2019
DOIs	https://doi.org/10.1016/j.kint.2019.03.006
Publication status	Published - Sept 2019

Keywords

artificial pancreas
closed-loop insulin delivery
glucose control
hemodialysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.kint.2019.03.006

https://www.kidney-international.org/article/S0085-2538(19)30322-9/fulltext

Cite this

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title = "Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis",

abstract = "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.",

keywords = "artificial pancreas, closed-loop insulin delivery, glucose control, hemodialysis",

author = "Lia Bally and Philipp Gubler and Hood Thabit and Sara Hartnell and Yue Ruan and Wilinska, {Malgorzata E} and Evans, {Mark L} and Mariam Semmo and Bruno Vogt and Coll, {Anthony P} and Christoph Stettler and Roman Hovorka",

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T1 - Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis

AU - Bally, Lia

AU - Gubler, Philipp

AU - Thabit, Hood

AU - Hartnell, Sara

AU - Ruan, Yue

AU - Wilinska, Malgorzata E

AU - Evans, Mark L

AU - Semmo, Mariam

AU - Vogt, Bruno

AU - Coll, Anthony P

AU - Stettler, Christoph

AU - Hovorka, Roman

PY - 2019/9

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N2 - 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.

AB - 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.

KW - artificial pancreas

KW - closed-loop insulin delivery

KW - glucose control

KW - hemodialysis

U2 - 10.1016/j.kint.2019.03.006

DO - 10.1016/j.kint.2019.03.006

M3 - Article

C2 - 31133457

SN - 0085-2538

VL - 96

SP - 593

EP - 596

JO - Kidney International

JF - Kidney International

IS - 3