{"title":"Automated Insulin Delivery Technology in the Hospital: Update on Safety and Efficacy Data","authors":"","doi":"10.1016/j.eprac.2024.07.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Automated insulin delivery (AID) systems are a rapidly growing component in the area of continuous subcutaneous insulin infusion (CSII) therapy. As more patients use these systems in the outpatient setting, it is important to assess safety if their use is allowed to continue in the inpatient setting.</div></div><div><h3>Methods</h3><div>Analysis was conducted of the records of patients using AID technology upon admission to our hospital between June 2020 and December 2022. Adverse events and glycemic control of AID users were compared with patients using non-AID systems and with patients who had CSII discontinued.</div></div><div><h3>Results</h3><div>There were 185 patients analyzed: 64 on AID, 86 on non-AID, and 35 who had CSII discontinued. The number of patients on AID increased over the course of the observation period, whereas non-AID users decreased. Pairwise comparisons indicated that patient-stay mean glucose levels and percentage of hypoglycemic events were similar between all groups, but the percentage of patient hyperglycemic measurements was significantly lower in the AID cohort. No adverse events (diabetic ketoacidosis, pump site complications, equipment malfunction) were reported in any either CSII cohort.</div></div><div><h3>Conclusion</h3><div>The type of CSII technology encountered in the hospital is shifting from non-AID toward AID technologies. This analysis supports earlier findings that outpatient AID systems can be successfully transitioned into the inpatient setting. Further study is needed to define if AID systems offer any advantage in glycemic control.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1530891X24006153","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Automated insulin delivery (AID) systems are a rapidly growing component in the area of continuous subcutaneous insulin infusion (CSII) therapy. As more patients use these systems in the outpatient setting, it is important to assess safety if their use is allowed to continue in the inpatient setting.
Methods
Analysis was conducted of the records of patients using AID technology upon admission to our hospital between June 2020 and December 2022. Adverse events and glycemic control of AID users were compared with patients using non-AID systems and with patients who had CSII discontinued.
Results
There were 185 patients analyzed: 64 on AID, 86 on non-AID, and 35 who had CSII discontinued. The number of patients on AID increased over the course of the observation period, whereas non-AID users decreased. Pairwise comparisons indicated that patient-stay mean glucose levels and percentage of hypoglycemic events were similar between all groups, but the percentage of patient hyperglycemic measurements was significantly lower in the AID cohort. No adverse events (diabetic ketoacidosis, pump site complications, equipment malfunction) were reported in any either CSII cohort.
Conclusion
The type of CSII technology encountered in the hospital is shifting from non-AID toward AID technologies. This analysis supports earlier findings that outpatient AID systems can be successfully transitioned into the inpatient setting. Further study is needed to define if AID systems offer any advantage in glycemic control.
背景:自动胰岛素输送系统(AID)是持续皮下胰岛素输注(CSII)治疗领域中发展迅速的组成部分。随着越来越多的患者在门诊环境中使用这些系统,如果允许在住院环境中继续使用这些系统,那么对其安全性进行评估就显得非常重要:方法:对 2020 年 6 月至 2022 年 12 月期间入住本院时使用 AID 技术的患者记录进行分析。将 AID 使用者的不良事件和血糖控制情况与使用非 AID 系统的患者以及停用 CSII 的患者进行比较:结果:共分析了 185 名患者:64 名使用 AID 系统,86 名使用非 AID 系统,35 名停用 CSII。在观察期间,使用 AID 的患者人数有所增加,而非 AID 用户则有所减少。配对比较结果表明,所有组别患者在留期间的平均血糖水平和低血糖事件的百分比相似,但在 AID 组别中,患者高血糖测量值的百分比明显较低。两组 CSII 患者均未发生不良事件(糖尿病酮症酸中毒、泵部位并发症、设备故障):结论:医院使用的 CSII 技术类型正从非 AID 转向 AID 技术。这项分析支持了之前的研究结果,即门诊 AID 系统可以成功过渡到住院环境中。还需要进一步研究来确定 AID 系统在血糖控制方面是否具有优势。
期刊介绍:
Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.