Evidence map›Paper›PMID 31002426›Full record

Trial reportDiabetic medicine : a journal of the British Diabetic Association2019

Closed-loop insulin delivery in end-of-life care: a case report.

C K Boughton, L Bally, S Hartnell, M Wilinska, A P Coll, M Evans, C Stettler, R Hovorka

Abstract readCase ReportsRandomized Controlled Trial
In one paragraph

Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Closed-loop insulin delivery in end-of-life care: a case report.Diabetic medicine : a journal of the British Diabetic Association · 2019
    Trial
  2. Review
  3. Article
  4. Benefits and Challenges of Diabetes Technology Use in Older Adults.Endocrinology and metabolism clinics of North America · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

C K BoughtonWellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID 0000-0003-3272-9544
L BallyBern University Hospital, Department of Diabetes Endocrinology, Clinical Nutrition and Metabolism, Bern, Switzerland.
S HartnellCambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, UK.
M WilinskaWellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
A P CollWellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
M EvansWellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
C StettlerBern University Hospital, Department of Diabetes Endocrinology, Clinical Nutrition and Metabolism, Bern, Switzerland.
R HovorkaWellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID 0000-0003-2901-461X

Funding

Wellcome Trust 100574/Z/12/Z
6 · The paper itself

Abstract

backgroundGlucose management for people with diabetes approaching the end of life can be very challenging. The aim is to balance a minimally invasive approach with avoidance of symptomatic hypo- and hyperglycaemia. CASE REPORT: We present a case of a hospitalized individual whose glucose was managed with closed-loop insulin delivery within a randomized controlled trial setting during a period of terminal illness. During the time in which closed-loop insulin delivery was used, glucose control was safe, with no glucose-related harm. The mean ± sd sensor glucose for this individual was 11.3 ± 4.3 mmol/l, percentage of time spent in target glucose range between 6 and 15 mmol/l was 70.5%, time spent in hypoglycaemia was 2.0% and time spent in significant hyperglycaemia >20 mmol/l was 2.6%.

conclusionClosed-loop systems can accommodate personalized glucose targets and highly variable insulin requirements. Factory-calibrated continuous glucose sensors and insulin pump therapy are less intrusive than finger-stick glucose measurements and insulin injections, respectively. Closed-loop systems may provide a safer and less burdensome approach to glucose management towards the end of life.

Indexed as

Insulin Infusion SystemsBlood GlucoseDiabetes Mellitus, Type 2Fatal OutcomeFemaleHumansInsulinTerminal CareBlood GlucoseInsulin

Identifiers

PMID31002426
PMCPMC6900195

What OpenQuestion holds

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Registered trials

None linked

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.