Insulin-Based Infusion System: Advancing the Development

Abstract

Background: Deviations in glucose control in critical care have been shown to increase mortality and morbidity. However, optimal glucose control through present technologies has shown to be a challenge. The insulin balanced infusion system (IBIS) is a new and emerging technology. Methods: The closed loop system was tested in a stress trial to evaluate glucose stability in response to various conditions in nonrandomized people with type 1 diabetes mellitus (n=12). The prototype used in this trial was based on intermittent capillary measurements. Results: Induced stresses in the study using unpredicted stimuli of intravenous or oral glucose and intravenous insulin boluses, was contained with glucose remaining in target 43.8% of the time. Mean increase in glucose concentration after glucose load was 17.4 mg/dl; after insulin bolus, no hypoglycemia (blood glucose less than 70 mg/dl) occurred. Conclusion: The use of IBIS proved safe and feasible under a wide range of conditions. The sensing and stress response of the IBIS demonstrated noticeable features.

Managing hyperglycemia during the COVID-19 pandemic: Improving outcomes using new technologies in intensive care

“…An adaptive counterbalancing system by Admetsys (Admetsys Corporation, Boston MA) has been shown in clinical trials of 43 insulin-requiring diabetic individuals to control plasma glucose in a target range of 4.4–6.9 mmol/L for 97% of the time without hypoglycemia (<3.9 mmol/L) during protocols which attempted to destabilize glucose control. 73 , 74 Additional in silico studies have confirmed a similar counterbalancing algorithm that achieves comparable results. Based on a total of 126,000 5-day simulations using 107,000,000 glucose samples, the time in target range (3.9–7.8 mmol/L) was 97.8%, hyperglycemia (>7.8 mmol/L) was noted 2.1% and hypoglycemia (<3.9 mmol/L) 0.09%.…”

Insulin Therapy for Hyperglycemia Management in Critically Ill Patients

“…The future may see technology continue to advance to where closed-loop systems may be utilized that continuously monitor glucose levels and automatically communicate with the insulin distribution system and adapt to changing insulin requirements. Preliminary studies have demonstrated the ability to achieve and maintain blood glucose goals safely [35]. Larger studies in critical care populations may be needed to assess the utility and economic feasibility of these technologies.…”