A case of type 1 diabetes with glycemic control using hybrid closed-loop therapy

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  • KUZUMI Hirotoshi
    Department of Clinical Laboratory and Clinical Engineering, Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka Prefectural Hospital Organization
  • OISHI Yuu
    Department of Clinical Laboratory and Clinical Engineering, Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka Prefectural Hospital Organization
  • MURAKOSHI Daiki
    Department of Clinical Laboratory and Clinical Engineering, Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka Prefectural Hospital Organization
  • HIRAMATSU Naoki
    Department of Clinical Laboratory and Clinical Engineering, Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka Prefectural Hospital Organization

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Other Title
  • ハイブリッドクローズドループ療法を用いて血糖管理を行った1型糖尿病の1症例
  • ハイブリッドクローズドループ リョウホウ オ モチイテ ケットウ カンリ オ オコナッタ 1ガタ トウニョウビョウ ノ 1 ショウレイ

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Abstract

<p>Continuous subcutaneous insulin infusion (CSII) and sensor-augmented pump (SAP) therapy in patients with type 1 diabetes are close to physiological insulin secretion because they can regulate basal insulin according to the amount of individual insulin. In January 2022, insulin pumps equipped with a hybrid closed-looped (HCL) system were made available in Japan. HCL therapy is a technology with which the amount of basal insulin can be automatically adjusted on the basis of glucose levels obtained from continuous glucose monitoring (CGM) using a glucose sensor. At our hospital, a clinical laboratory technician is in charge of the introduction and guidance on the use of continuous insulin pumps. We report a case of type 1 diabetes in which blood glucose level was controlled using HCL therapy. Glycemic control with SAP therapy resulted in HbA1c levels of 7.7–8.2%. After the introduction of HCL therapy, HbA1c levels decreased to 7.0–7.2%, and blood glucose levels tended to decrease. Furthermore, time in range (TIR) increased from 51–56% with SAP therapy to 64–69% with HCL therapy. HCL therapy can increase TIR without promoting hypoglycemic events and is effective for improving patient quality of life and preventing diabetic complications.</p>

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