Fully closed-loop insulin delivery in inpatients receiving nutritional support: a two-centre, open-label, randomised controlled trial

Publication date: Available online 29 March 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Charlotte K Boughton, Lia Bally, Franco Martignoni, Sara Hartnell, David Herzig, Andreas Vogt, Maria M Wertli, Malgorzata E Wilinska, Mark L Evans, Anthony P Coll, Christoph Stettler, Roman HovorkaSummaryBackgroundGlucose management is challenging in patients who require nutritional support in hospital. We aimed to assess whether fully closed-loop insulin delivery would improve glycaemic control compared with conventional subcutaneous insulin therapy in inpatients receiving enteral or parenteral nutrition or both.MethodsWe did a two-centre (UK and Switzerland), open-label, randomised controlled trial in adult inpatients receiving enteral or parenteral nutrition (or both) who required subcutaneous insulin therapy. Patients recruited from non-critical care surgical and medical wards were randomly assigned (1:1) using a computer-generated minimisation schedule (stratified by type of nutritional support [parenteral nutrition on or off] and pre-study total daily insulin dose [<50 or ≥50 units]) to receive fully closed-loop insulin delivery with faster-acting insulin aspart (closed-loop group) or conventional subcutaneous insulin therapy (control group) given in accordance with local clinical practice. Continuous glucose monitoring in the control group was masked to patients, ward staff, and investigators. Patients were followed up for a maximum of 15 days or until hospital d...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research