Endocrinology · 2 h ago
Hybrid closed-loop therapy improves time in range after total pancreatectomy
In a single-center prospective observational study of 15 adults with diabetes after total pancreatectomy, time in range increased after transition from multiple daily injections to advanced hybrid closed-loop therapy. Improvements were broadly maintained over six months, but the small, nonrandomized study requires confirmation.
- Median time in range increased from 53.9% to 72.0%.
- CGM improvements were broadly stable over six months.
- Hypoglycemic-event frequency did not significantly change.
- Larger controlled studies are needed.
This single-center prospective observational study evaluated 15 adults with diabetes shortly after total pancreatectomy who transitioned from multiple daily insulin injections (MDI) to advanced hybrid closed-loop (AHCL) therapy. The primary outcome was continuous glucose monitoring (CGM) time in range (TIR; 70–180 mg/dL) during the first month of AHCL compared with the final month on MDI. CGM outcomes were followed for six months; an exploratory comparison included 28 patients who remained on MDI.
Median TIR rose from 53.9% on MDI to 72.0% in the first month of AHCL (P<0.01). Time above range, mean glucose, glycemic risk index, and glucose variability also decreased, with CGM outcomes broadly stable during follow-up. Time below range and hypoglycemic-event frequency did not change significantly, while median event duration fell from 55.2 to 35.0 minutes (P<0.01). Anxiety and fear of hypoglycemia decreased; other patient-reported outcomes did not change significantly. In the exploratory comparison, AHCL recipients had higher TIR and lower glycemic risk index than patients remaining on MDI. The selected, small cohort and nonrandomized comparison limit conclusions; larger controlled studies are needed to confirm benefits and durability.
In practice
For adults with diabetes after total pancreatectomy, this small prospective study suggests that transition from multiple daily injections to advanced hybrid closed-loop therapy may improve time in range without a significant increase in time below range. Improvements were observed over six months, but the study was single-center, included only 15 selected patients, and was not randomized; the comparison with patients remaining on injections was exploratory. These findings support further evaluation, not a definitive change in treatment practice.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
The Journal of Clinical Endocrinology & Metabolism: Glycemic And Patient-Reported Outcomes After Transition To Advanced Hybrid Closed-Loop System In Patients After Total Pancreatectomy ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.