Early use of hybrid closed-loop following total pancreaticoduodenectomy.

• Tác giả: Jean-Philippe Adam, Laurence Baillet-Blanco, Marion Camoin, Laurence Chiche, Alice Larroumet, Christophe Laurent, Arthur Marichez, Kamel Mohammedi, Vincent Rigalleau
• Ngôn ngữ: eng
• Thông tin xuất bản: France : Diabetes & metabolism , 2025
• Bộ sưu tập: NCBI
• ID: 731326

Tóm tắt

 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.