Trial reportCritical care (London, England)2013
Feasibility of fully automated closed-loop glucose control using continuous subcutaneous glucose measurements in critical illness: a randomized controlled trial.
Trial report in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01440842 (An Open-label, Single-centre, Randomised Controlled Trial to Assess the Safety and Efficacy of Automated Closed-loop Blood Glucose Control in Comparison With Standard Care in Adults in Intensive Care Unit), which is not on this map. Cited by 52 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
An Open-label, Single-centre, Randomised Controlled Trial to Assess the Safety and Efficacy of Automated Closed-loop Blood Glucose Control in Comparison With Standard Care in Adults in Intensive Care Unit
Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Performance of closed-loop systems for intravenous drug administration: a systematic review and meta-analysis of randomised controlled trials.Journal of clinical monitoring and computing · 2024Pooled it
- Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline.Journal of diabetes science and technology · 2020Guideline
- Feasibility of automated insulin delivery guided by continuous glucose monitoring in preterm infants.Archives of disease in childhood. Fetal and neonatal edition · 2020Trial
- Fully closed-loop insulin delivery in inpatients receiving nutritional support: a two-centre, open-label, randomised controlled trial.The lancet. Diabetes & endocrinology · 2019Trial
- Accuracy and reliability of a subcutaneous continuous glucose monitoring device in critically ill patients.Journal of clinical monitoring and computing · 2018Trial
- Trial
- Adaptability of Closed Loop During Labor, Delivery, and Postpartum: A Secondary Analysis of Data from Two Randomized Crossover Trials in Type 1 Diabetes Pregnancy.Diabetes technology & therapeutics · 2018Trial
- Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial.Critical care (London, England) · 2014Trial
- Accuracy of subcutaneous continuous glucose monitoring in critically ill adults: improved sensor performance with enhanced calibrations.Diabetes technology & therapeutics · 2014Trial
- Group-based trajectory modeling identifies distinct glycemic patterns predictive of mortality in aneurysmal subarachnoid hemorrhage.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Flash Glucose Monitoring for Predicting Cardiogenic Shock Occurrence in Critically Ill Patients: A Retrospective Pilot Study.Diagnostics (Basel, Switzerland) · 2025Article
- Toward Automation: The Road Traveled and Road Ahead for Integrating Automated Insulin Delivery into Inpatient Care.Diabetes technology & therapeutics · 2025Review
- Review Article - Diabetes Technology in the Hospital: An Update.Current diabetes reports · 2024Review
- Continuous Glucose Monitoring in the Intensive Care Unit.Journal of diabetes science and technology · 2023Article
- COVID-19: Diabetes Perspective-Pathophysiology and Management.Pathogens (Basel, Switzerland) · 2023Review
- Continuous glucose monitoring for children with hypoglycaemia: Evidence in 2023.Frontiers in endocrinology · 2023Review
- Clinical challenges of glycemic control in the intensive care unit: A narrative review.World journal of clinical cases · 2022Review
- Machine-assisted nutritional and metabolic support.Intensive care medicine · 2022Article
- Rationale and design of a randomized controlled clinical trial; Titration of Oxygen Levels (TOOL) during mechanical ventilation.Contemporary clinical trials · 2022Article
- Glycemic control in critically ill patients with or without diabetes.BMC anesthesiology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
introductionClosed-loop (CL) systems modulate insulin delivery according to glucose levels without nurse input. In a prospective randomized controlled trial, we evaluated the feasibility of an automated closed-loop approach based on subcutaneous glucose measurements in comparison with a local sliding-scale insulin-therapy protocol.
methodsTwenty-four critically ill adults (predominantly trauma and neuroscience patients) with hyperglycemia (glucose, ≥10 mM) or already receiving insulin therapy, were randomized to receive either fully automated closed-loop therapy (model predictive control algorithm directing insulin and 20% dextrose infusion based on FreeStyle Navigator continuous subcutaneous glucose values, n = 12) or a local protocol (n = 12) with intravenous sliding-scale insulin, over a 48-hour period. The primary end point was percentage of time when arterial blood glucose was between 6.0 and 8.0 mM.
resultsThe time when glucose was in the target range was significantly increased during closed-loop therapy (54.3% (44.1 to 72.8) versus 18.5% (0.1 to 39.9), P = 0.001; median (interquartile range)), and so was time in wider targets, 5.6 to 10.0 mM and 4.0 to 10.0 mM (P ≤ 0.002), reflecting a reduced glucose exposure >8 and >10 mM (P ≤ 0.002). Mean glucose was significantly lower during CL (7.8 (7.4 to 8.2) versus 9.1 (8.3 to 13.0] mM; P = 0.001) without hypoglycemia (<4 mM) during either therapy.
conclusionsFully automated closed-loop control based on subcutaneous glucose measurements is feasible and may provide efficacious and hypoglycemia-free glucose control in critically ill adults.
trial registrationClinicalTrials.gov Identifier, NCT01440842.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.