Perioperative intensive insulin therapy using an artificial endocrine pancreas with closed-loop glycemic control system: the effects of no hypoglycemia

Abstract Background We examined whether perioperative intensive insulin therapy (IIT) using an artificial pancreas (AP) with a closed-loop glycemic control system can be used to prevent hypoglycemia in surgical patients. Methods Between 2006 and 2012, perioperative glycemic control using an AP was p...

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Bibliographic Details
Published in:The American journal of surgery 2014-06, Vol.207 (6), p.935-941
Main Authors: Hanazaki, Kazuhiro, M.D.,Ph.D, Kitagawa, Hiroyuki, M.D.,Ph.D, Yatabe, Tomoaki, M.D.,Ph.D, Munekage, Masaya, M.D.,Ph.D, Dabanaka, Ken, M.D.,Ph.D, Takezaki, Yuka, Tsukamoto, Yuuki, Ph.D, Asano, Takuji, Ph.D, Kinoshita, Yoshihiko, Namikawa, Tsutomu, M.D.,Ph.D
Format: Article
Language:English
Subjects:
Artificial pancreas
Blood Glucose - analysis
Closed-loop glycemic control system
Female
Glucose
Humans
Hyperglycemia
Hypoglycemia
Hypoglycemia - prevention & control
Insulin
Insulin - therapeutic use
Male
Mortality
Pancreas, Artificial
Perioperative Care
Perioperative intensive insulin therapy
Retrospective Studies
Stable glycemic control
Surgery
Surgical outcomes
Surgical Procedures, Operative
Treatment Outcome
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Summary:Abstract Background We examined whether perioperative intensive insulin therapy (IIT) using an artificial pancreas (AP) with a closed-loop glycemic control system can be used to prevent hypoglycemia in surgical patients. Methods Between 2006 and 2012, perioperative glycemic control using an AP was performed in 427 patients undergoing general surgery. A total of 305 patients undergoing IIT using an AP in the target blood glucose range of 80 to 110 mg/dL were enrolled in the study. Data were collected prospectively and were reviewed or analyzed retrospectively. Results No patients had hypoglycemia. Perioperative mean blood glucose level and achievement rates in target blood glucose range of 80 to 110 mg/dL were 100.5 ± 11.9 mg/dL and 88.1% ± 16.0%, respectively. For the 3 primary operative methods, including hepatic, pancreatic, and esophageal resections, there were no significant differences in glycemic control stability between the types of surgery. Conclusion Perioperative IIT using an AP with a closed-loop glycemic control system can be used to prevent hypoglycemia and maintain stable glycemic control with less variability of blood glucose concentration.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2013.07.048