■ 試験デザイン
T: 試験デザイン
randomized, open-label trial

P: 患者背景

E: 介入 closed-loop
C:比較 通常インスリン
O: アウトカム 血糖値が100~180mg/dにおさまった時間の割合

■ 結果

The mean (±SD) percentage of time that the sensor glucose measurement was in the target range was 65.8±16.8% in the closed-loop group and 41.5±16.9% in the control group, a difference of 24.3±2.9 percentage points (95% confidence interval [CI], 18.6 to 30.0; P<0.001); values above the target range were found in 23.6±16.6% and 49.5±22.8% of the patients, respectively, a difference of 25.9±3.4 percentage points (95% CI, 19.2 to 32.7; P<0.001). The mean glucose level was 154 mg per deciliter (8.5 mmol per liter) in the closed-loop group and 188 mg per deciliter (10.4 mmol per liter) in the control group (P<0.001). There was no significant between-group difference in the duration of hypoglycemia (as defined by a sensor glucose measurement of <54 mg per deciliter; P=0.80) or in the amount of insulin that was delivered (median dose, 44.4 U and 40.2 U, respectively; P=0.50). No episode of severe hypoglycemia or clinically significant hyperglycemia with ketonemia occurred in either trial group.


Closed-loopによる血糖管理は一般病床でも効果ありそう。 って当たり前だろという論文ですが、病院で入院患者さんの血糖管理をしていたことを思い出しながら読んでいました。




■ 参照文献
Bally L et al., N Engl J Med. 2018 Aug 9;379(6):547-556.
PMID: 29940126

名古屋糖尿病内科クリニック 院長・糖尿病専門医 平井博之