Early use of hybrid closed-loop following total pancreaticoduodenectomy

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2025-02-02 DOI:10.1016/j.diabet.2025.101619

Alice Larroumet , Arthur Marichez , Marion Camoin , Laurence Baillet-Blanco , Jean-Philippe Adam , Christophe Laurent , Vincent Rigalleau , Kamel Mohammedi , Laurence Chiche

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引用次数: 0

Abstract

Diabetes secondary to total pancreaticoduodenectomy (TP) is challenging to manage due to high glycemic variability and risk of hypoglycemia, in a frail population. We report the case of four patients with no prior diabetes who underwent TP. Three of four patients needed artificial nutritional support. Hybrid closed-loop (HCL) insulin therapy was initiated within 12 weeks of surgery. After 90 days of HCL treatment, continuous glucose measurement showed a 70.4 ± 11.8 % time in range (versus 43 ± 6.5 % before HCL); 0.2 ± 0.2 % time below range (versus 0.6 ± 0.5 % before HCL); 23.8 ± 9.1 % time above range 180–250 mg/dl (versus 22.9 ± 6.1 % before HCL); 4.2 ± 2.5 % time above range > 250 mg/dl (versus 33.8 ± 3.9 % before HCL). The glucose management indicator improved from 8.5 ± 0.6 % to 6.9 ± 0.6 %. There was no severe hypoglycemia or need for unplanned medical attention. Early post-operative use of HCL allowed our patients to achieve safely optimal glycemic control after TP.

查看原文本刊更多论文

混合闭环在全胰十二指肠切除术后的早期应用。

糖尿病继发于全胰十二指肠切除术（TP）是具有挑战性的管理，由于高血糖变异性和低血糖的风险，在虚弱的人群。我们报告4例既往无糖尿病的患者接受TP治疗。4名患者中有3名需要人工营养支持。混合闭环（HCL）胰岛素治疗在手术12周内开始。HCL治疗90天后，连续血糖测量显示70.4±11.8%的时间在范围内（HCL治疗前为43±6.5%）；低于范围0.2±0.2%的时间（HCL前为0.6±0.5%）；180-250 mg/dl以上时间为23.8±9.1%（盐酸前为22.9±6.1%）；在> ~ 250mg /dl以上时间为4.2±2.5% （HCL前为33.8±3.9%）。血糖管理指标由8.5±0.6%提高到6.9±0.6%。没有严重的低血糖，也不需要计划外的医疗照顾。术后早期使用HCL使我们的患者在TP后获得安全的最佳血糖控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.