Insulin-Based Infusion System: Preliminary Study

Abstract

Background: Optimal glucose control has been shown to be useful in critical care as well as in other settings. Glucose concentrations in patients admitted to critical care are characterized by marked variability and hypoglycemia due to inadequate sensing and treatment technologies. Methods:The insulin balanced infusion system (IBIS) is a closed-loop system that uses a system controller, two syringe pumps, and capillary glucose sensor intravenously infusing regular insulin and/or dextrose. The IBIS performance was evaluated in terms of glucose stability in response to various conditions in subjects with type 1 and insulin requiring type 2 diabetes mellitus (n = 15) with frequent intermittent capillary measurements, entered into the system and an adaptive algorithm adjusting the treatment modalities without other nursing intervention.Results: Target glucose concentrations (80-125 mg/dl) were achieved from hyperglycemic levels in 2.49 hours in the first study with mean and standard deviation of 105.2 mg/dl and 11.5 mg/dl, respectively. Conclusion:Preliminary studies using a prototype closed-loop glucose control system for critical care produced noticeable results. Improvements were initiated within the system and further studies performed.

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%.…”

Bioresponsive Functional Phenylboronic Acid-Based Delivery System as an Emerging Platform for Diabetic Therapy

“…It not only stabilizes the blood sugar level at any time and improves the utilization rate of insulin, but also extends the time of drug administration and reduces the pain of patients with diabetes. 8 Currently, there are three common glucose-sensitive drug systems, phenylboronic acid (PBA) and its derivatives, concanavalin A (Con A), and glucose oxidase (GOD). 9 Con A and glucose oxidase systems are proteins that exhibit volatile inactivation, poor stability, and high cost.…”

Regarding a successful treatment with artificial pancreas for a patient who attempted suicide using a high‐dose insulin s.c. injection

“…This system, like the STG-55, is intended to deliver both insulin and glucose i.v. 3 Almost every marketed wearable AP system delivers only insulin to lower elevated BG concentrations and nothing to raise the BG concentration in the event of hypoglycemia. These systems respond to hypoglycemia by halting insulin delivery, but they do not administer any agent to actively raise the BG concentration.…”

“…Another AP intended for hospital use is being developed by Admetsys. This system, like the STG‐55, is intended to deliver both insulin and glucose i.v 3 . Almost every marketed wearable AP system delivers only insulin to lower elevated BG concentrations and nothing to raise the BG concentration in the event of hypoglycemia.…”