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Case Reports
. 2021 Jan 6;7(3):184-188.
doi: 10.1016/j.aace.2020.12.013. eCollection 2021 May-Jun.

Efficacy of Hybrid Closed-Loop Insulin Delivery System in a Hospital Setting: A Case Series

Zulekha Atif  1 , Amanda Halstrom  2 , Virginia Peragallo-Dittko  2 , Stanislaw P Klek  3
Affiliations
Case Reports

Efficacy of Hybrid Closed-Loop Insulin Delivery System in a Hospital Setting: A Case Series

Zulekha Atif et al. AACE Clin Case Rep. .

Abstract

Objective: We report a case series of 4 patients with type 1 diabetes who used hybrid closed-loop insulin pumps (Medtronic MiniMed 670 G) during hospitalization.

Methods: Clinical data and point-of-care glucose values are presented for each patient. Glucose values are shown graphically while in manual mode as well as in auto mode.

Results: The first case was a 30-year-old man admitted for pancreatitis. Mean point-of-care blood glucose was 165.7 mg/dL while in auto mode, without hypoglycemia, compared with 221 mg/dL while in manual mode. The second case was a 28-year-old woman who was admitted for a laparoscopic cholecystectomy. Mean point-of-care blood glucose in auto mode was 131.3 mg/dL, without hypoglycemia, compared with 117.6 mg/dL while in manual mode. The third case was a 46-year-old man admitted to the intensive care unit for influenzal pneumonia. Mean point-of-care blood glucose in auto mode was 159.1 mg/dL without hypoglycemia, compared with 218.5 mg/dL while in manual mode. The fourth case was a 60-year-old man who remained in auto mode throughout his hospitalization except for a period when he removed his pump for an endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. His mean point-of-care blood glucose while in auto mode was 156.8 mg/dL without hypoglycemia.

Conclusion: These case reports support the use of hybrid closed-loop insulin-pump therapy in the inpatient setting to maintain inpatient glycemic targets and avoid hypoglycemia when part of an institution-sanctioned strategy for safe use of insulin pumps that includes point-of-care blood glucose monitoring.

Keywords: CGM, continuous glucose monitor; FDA, Food and Drug Administration; HCL, hybrid closed-loop; MARD, mean absolute relative difference; T1DM, type 1 diabetes mellitus.

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Figures

Fig. 1
Fig. 1
Glucose trends for for case 1.
Fig. 2
Fig. 2
Glucose trends for case 2.
Fig. 3
Fig. 3
Glucose trends for case 3.
Fig. 4
Fig. 4
Glucose trends for case 4.
See this image and copyright information in PMC

References

    1. Yeh H.C., Brown T.T., Maruthur N. Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: a systematic review and meta-analysis. Ann Intern Med. 2012;157(5):336–347. - PubMed
    1. Sherr J., Tamborlane W.V. Past, present, and future of insulin pump therapy: better shot at diabetes control. Mt Sinai J Med. 2008;75(4):352–361. - PMC - PubMed
    1. Umpierrez G.E., Klonoff D.C. Diabetes technology update: use of insulin pumps and continuous glucose monitoring in the hospital. Diabetes Care. 2018;41(8):1579–1589. - PMC - PubMed
    1. US Food and Drug Administration FDA approves first automated insulin delivery device for type 1 diabetes. https://www.fda.gov/news-events/press-announcements/fda-approves-first-a...
    1. Ly T.T., Roy A., Grosman B. Day and night closed-loop control using the integrated Medtronic hybrid closed-loop system in Type 1 diabetes at diabetes camp. Diabetes Care. 2015;38(7):1205–1211. - PubMed

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