title: Comparison between a novel and conventional artificial pancreas for perioperative glycemic control using a closed-loop system.
abstract: This clinical study aimed to compare a novel and conventional artificial pancreas (AP) used in surgical patients for perioperative glycemic control, with respect to usability, blood glucose measurements, and glycemic control characteristics. From July in 2010 to March in 2015, 177 patients underwent perioperative glycemic control using a novel AP. Among them, 166 patients were eligible for inclusion in this study. Intensive insulin therapy (IIT) targeting a blood glucose range of 80-110 mg/dL was implemented in 82 patients (49 %), and the remaining 84 patients (51 %) received a less-intensive regime of insulin therapy. Data were collected prospectively and were reviewed or analyzed retrospectively. A comparison study of 324 patients undergoing IIT for glycemic control using a novel (n = 82) or conventional AP (n = 242) was conducted retrospectively. All patients had no hypoglycemia. The comparison study revealed no significant differences in perioperative mean blood glucose level, achievement rates for target blood glucose range, and variability in blood glucose level achieved with IIT between the novel AP and conventional AP groups. The usability, performance with respect to blood glucose measurement, and glycemic control characteristics of IIT were comparable between novel and conventional AP systems. However, the novel AP was easier to manipulate than the conventional AP due to its smaller size, lower weight, and shorter time for preparation. In the near future, this novel AP system might be accepted worldwide as a safe and useful device for use in perioperative glycemic control.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku City, Kochi, 783-8505, Japan. tsutomun@kochi-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku City, Kochi, 783-8505, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Munekage
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku City, Kochi, 783-8505, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.affiliation: Department of Anesthesiology, Kochi Medical School, Kochi University, Nankoku City, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yatabe
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku City, Kochi, 783-8505, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Nikkiso Co. LTD, Tokyo, Japan.
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Tsukamoto
authors.affiliation: Nikkiso Co. LTD, Tokyo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hirano
authors.affiliation: Nikkiso Co. LTD, Tokyo, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Asano
authors.affiliation: Nikkiso Co. LTD, Tokyo, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kinoshita
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku City, Kochi, 783-8505, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000628:therapy*; D007003:Hypoglycemia / Q000097:blood / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D019397:Pancreas, Artificial; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Closed-loop glycemic control system; Hypoglycemia; Intensive insulin therapy; Novel artificial pancreas; Perioperative glycemic control