Practical Closed-Loop Insulin Delivery

A System for the Maintenance of Overnight Euglycemia and the Calculation of Basal Insulin Requirements in Insulin-Dependent Diabetics

  1. NEIL H. WHITE, M.D.;
  2. DONALD SKOR, M.D.; and
  3. JULIO V. SANTIAGO, M.D.
  1. St. Louis, Missouri

    Abstract

    We evaluated a practical closed-loop system of insulin delivery consisting of hourly blood glucose determinations using glucose oxidase reagent strips and an intravenous infusion of insulin controlled by a commonly available controller. In 25 insulin-dependent diabetic subjects, this system was successful in achieving and maintaining near euglycemia (blood glucose, 101 ± 2 mg/dL, mean ± SE) in the fasting state between 0200 and 0800 hours. This system may be useful in the management of insulin-dependent diabetic patients in various hospital settings. Also, in 10 subjects treated subsequently using a continuous subcutaneous insulin infusion, the mean hourly insulin infusion rate using the described system correlated well (r = 0.92) with the optimal overnight basal rate needed during continous subcutaneous insulin infusion therapy.

    Article and Author Information

    • ▸From the Edward Mallinckrodt Department of Pediatrics, and the Department of Medicine, Washington University School of Medicine; and the Division of Endocrinology and Metabolism, St. Louis Children's Hospital; St. Louis, Missouri.

    • Grant support: in part by National Institutes of Health grants RR-00036 and AM20579.

    • ▸Requests for reprints should be addressed to Neil H. White, M.D.; St. Louis Children's Hospital, P.O. Box 14871; St. Louis, MO 63178.

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