Day-to-day variability of insulin requirements in the inpatient setting: Observations during fully closed-loop insulin delivery

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Abstract

The aim of this study was to characterize the variability of exogenous insulin requirements during fully closed-loop insulin delivery in hospitalized patients with type 2 diabetes or new-onset hyperglycaemia, and to determine patient-related characteristics associated with higher variability of insulin requirements. We retrospectively analysed data from two fully closed-loop inpatient studies involving adults with type 2 diabetes or new-onset hyperglycaemia requiring insulin therapy. The coefficient of variation quantified day-to-day variability of exogenous insulin requirements during up to 15 days using fully automated closed-loop insulin delivery. Data from 535 days in 67 participants were analysed. The coefficient of variation of day-to-day exogenous insulin requirements was 30% ± 16%, and was higher between nights than between any daytime period (56% ± 29% overnight [11:00 pm to 4:59 am] compared with 41% ± 21% in the morning [5:00 am to 10:59 am], 39% ± 15% in the afternoon [11:00 am to 4:59 pm] and 45% ± 19% during the evening [5:00 pm to 10:59 pm]; all P < 0.01). There is high day-to-day variability of exogenous insulin requirements in inpatients, particularly overnight, and diabetes management approaches should account for this variability.

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APA

Boughton, C. K., Daly, A., Thabit, H., Hartnell, S., Herzig, D., Vogt, A., … Hovorka, R. (2021). Day-to-day variability of insulin requirements in the inpatient setting: Observations during fully closed-loop insulin delivery. Diabetes, Obesity and Metabolism, 23(8), 1978–1982. https://doi.org/10.1111/dom.14396

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