Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2019 Sep;13(5):941-948.
doi: 10.1177/1932296819832876. Epub 2019 Mar 10.

Insulin-Based Infusion System: Advancing the Development

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

Insulin-Based Infusion System: Advancing the Development

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

Abstract

Background: Deviations in glucose control in critical care have been shown to increase mortality and morbidity. However, optimal glucose control through present technologies has shown to be a challenge. The insulin balanced infusion system (IBIS) is a new and emerging technology.

Methods: The closed loop system was tested in a stress trial to evaluate glucose stability in response to various conditions in nonrandomized people with type 1 diabetes mellitus (n=12). The prototype used in this trial was based on intermittent capillary measurements.

Results: Induced stresses in the study using unpredicted stimuli of intravenous or oral glucose and intravenous insulin boluses, was contained with glucose remaining in target 43.8% of the time. Mean increase in glucose concentration after glucose load was 17.4 mg/dl; after insulin bolus, no hypoglycemia (blood glucose less than 70 mg/dl) occurred.

Conclusion: The use of IBIS proved safe and feasible under a wide range of conditions. The sensing and stress response of the IBIS demonstrated noticeable features.

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

PubMed Disclaimer

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: Tim Valk is full-time employee of Admetsys.

Figures

Figure 1.
Figure 1.
Aggregate analysis with repeated stabilization and extended maintenance of the stress trial population.
Figure 2.
Figure 2.
The distribution for time to normalization across all trials.
Figure 3.
Figure 3.
Aggregated analysis of the carbohydrate loading event. The left side of the figure shows glucose levels from the time of administration of the high-carbohydrate meal till the time of restoration of the normoglycemic target range. The right side of figure depicts the following two hours after restoration of the normoglycemic target range.
Figure 4.
Figure 4.
Plot of the summary statistics for the intravenous glucose infusion response. The left chart shows the glucose levels at the time of administration and the following two hours, and the right chart shows the subsequent two hours.
Figure 5.
Figure 5.
The descriptive statistics summarizing intravenous insulin bolus response, from administration to the following hour.
See this image and copyright information in PMC

References

    1. Lazar HL, Chipkin SR, Fitzgerald CA, Bao Y, Cabral H, Apstein CS. Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events. Circulation. 2004;109:1497-1502. - PubMed
    1. Szabo Z, Hakanson E, Svedjeholm R. Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting. Ann Thorac Surg. 2002;74:712-719. - PubMed
    1. Cohen Y, Raz I, Merin G, Mozes B. Comparison of factors associated with 30-day mortality after coronary artery bypass grafting in patients with versus without diabetes mellitus. Israeli Coronary Artery Bypass (ISCAB) Study Consortium. Am J Cardiol. 1998;81:7-11. - PubMed
    1. Carson JL, Scholz PM, Chen AY, Peterson ED, Gold J, Schneider SH. Diabetes mellitus increases short-term mortality and morbidity in patients undergoing coronary artery bypass graft surgery. J Am Coll Cardiol. 2002;40:418-423. - PubMed
    1. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78:1471-1478. - PubMed

Publication types