Acta Diabetologica

, Volume 56, Issue 7, pp 807–809 | Cite as

Normoglycaemic control with a selfmade fully closed-loop insulin delivery system during emergency surgery: an extemporaneous stress test

  • Andreas HolsteinEmail author
  • Bruno Bolli
Case Report

Dear Editor,

Hybrid closed-loop insulin delivery systems have entered clinical use and progressed from supervised safety trials [1] to free-living home studies [2]. In 2017, the Federal Drug Administration (FDA) approved the first hybrid closed-loop system [3] making the “Artificial Pancreas” a realistic therapeutic option for an eligible proportion of people with type 1 diabetes mellitus (T1DM). Hybrid closed-loop insulin delivery systems are characterized by continuous glucose monitoring and algorithm-directed insulin pump delivery providing automatically the basal insulin requirement. However, in contrast to a fully closed-loop approach, prandial insulin boluses need still to be carried out by the patient himself.

Generally, affected people are frequently impatient with the progress of medical developments, completion of clinical trials or final regulatory approvals. Some individuals try to improve and advance medical technology more rapidly by themselves. In particular, there is an...


Diabetes type 1 Closed insulin delivery system Perioperative glycaemic control 


Compliance with ethical standards

Conflict of interest

The authors declare no duality of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

The patient gave his signed consent for the material presented in the publication.


  1. 1.
    Bergenstal RM, Garg S, Weinzimer SA, et al (2016) Safety of a hybrid closed-loop insulin delivery system in patients with Type 1 diabetes. JAMA 316:1407–1408CrossRefGoogle Scholar
  2. 2.
    Tauschmann M, Thabit H, Bally L et al (2018) Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, 12-week randomised trial. Lancet 392:1321–1329CrossRefGoogle Scholar
  3. 3.
    FDA News Release. FDA approves first automated insulin delivery device for Type 1 diabetes.
  4. 4.
  5. 5.
    Bally L, Thabit H, Hartnell S et al (2018) Closed-loop insulin delivery for glycemic control in noncritical care. N Engl J Med 379:547–556CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  1. 1.First Department of MedicineLippe-Detmold HospitalDetmoldGermany
  2. 2.WeAreNotWaiting / User of closed loop with AndroidAPSLageGermany

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