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Clinical Trial
. 2019 Sep;13(5):935-940.
doi: 10.1177/1932296818821349. Epub 2019 Jan 24.

Insulin-Based Infusion System: Preliminary Study

Nasseh Hashemi  1   2 , Tim Valk  3 , Kim Houlind  2   4 , Niels Ejskjaer  2   5
Affiliations
Clinical Trial

Insulin-Based Infusion System: Preliminary Study

Nasseh Hashemi et al. J Diabetes Sci Technol. 2019 Sep.

Abstract

Background: Optimal glucose control has been shown to be useful in critical care as well as in other settings. Glucose concentrations in patients admitted to critical care are characterized by marked variability and hypoglycemia due to inadequate sensing and treatment technologies.

Methods: The insulin balanced infusion system (IBIS) is a closed-loop system that uses a system controller, two syringe pumps, and capillary glucose sensor intravenously infusing regular insulin and/or dextrose. The IBIS performance was evaluated in terms of glucose stability in response to various conditions in subjects with type 1 and insulin requiring type 2 diabetes mellitus (n = 15) with frequent intermittent capillary measurements, entered into the system and an adaptive algorithm adjusting the treatment modalities without other nursing intervention.

Results: Target glucose concentrations (80-125 mg/dl) were achieved from hyperglycemic levels in 2.49 hours in the first study with mean and standard deviation of 105.2 mg/dl and 11.5 mg/dl, respectively.

Conclusion: Preliminary studies using a prototype closed-loop glucose control system for critical care produced noticeable results. Improvements were initiated within the system and further studies performed.

Trial registration: ClinicalTrials.gov NCT01291719.

Keywords: automated glucose monitoring; closed-loop glucose control; critical care glucose control; glucose stabilization trial.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: TV is a full-time employee of Admetsys.

Figures

Figure 1.
Figure 1.
The tightness of control and target convergence with decreasing variability of the blood glucose of the subjects. The figure illustrates the progressive suppression of variability, simultaneous to correction of hyperglycemia.
Figure 2.
Figure 2.
Observed range of glucose values, seen as the outer band, and standard deviation, seen as the darker inner band, plotted relative to the mean, shown as the zero reference line.
Figure 3.
Figure 3.
Target range stability once blood glucose levels had normalized. Values are approximately normally distributed with two standard deviations (95% threshold) within the target range (80-125 mg/dl).
See this image and copyright information in PMC

References

    1. Furnary AP, Zerr KJ, Grunkemeier GL. et al. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999;67:352-360; discussion 60-62. - PubMed
    1. Lauruschkat AH, Arnrich B, Albert AA. et al. Prevalence and risks of undiagnosed diabetes mellitus in patients undergoing coronary artery bypass grafting. Circulation. 2005;112:2397-2402. - PubMed
    1. Schmeltz LR, DeSantis AJ, Thiyagarajan V. et al. Reduction of surgical mortality and morbidity in diabetic patients undergoing cardiac surgery with a combined intravenous and subcutaneous insulin glucose management strategy. Diabetes Care. 2007;30:823-828. - PubMed
    1. Thourani VH, Weintraub WS, Stein B. et al. Influence of diabetes mellitus on early and late outcome after coronary artery bypass grafting. Ann Thorac Surg. 1999;67:1045-1052. - PubMed
    1. Weintraub WS, Wenger NK, Jones EL, Craver JM, Guyton RA. Changing clinical characteristics of coronary surgery patients. Differences between men and women. Circulation. 1993;88:II79-II86. - PubMed

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