Effect of intensive insulin therapy using a closed-loop glycemic control system in hepatic resection patients: a prospective randomized clinical trial

  1. Takehiro Okabayashi, MD (tokabaya{at}kochi-u.ac.jp)1,
  2. Isao Nishimori, MD2,
  3. Hiromichi Maeda, MD1,
  4. Koichi Yamashita, MD3,
  5. Tomoaki Yatabe, MD3 and
  6. Kazuhiro Hanazaki, MD1
  1. 1Department of Surgery
  2. 2Department of Gastroenterology and Hepatology
  3. 3Department of Anesthesiology and Critical Care Medicine, Kochi Medical School


    Objective: Intensive insulin therapy (IIT) reduces morbidity and mortality in patients in surgical intensive care units. The aim of this study is to assess the effect of intensive insulin therapy using a closed-loop system in hepatectomized patients.

    Methods: Patients were randomly assigned to receive IIT using a closed-loop system: an artificial pancreas (AP group) or conventional insulin therapy using the sliding scale method (SS group).

    Results: The incidence of surgical site infection (SSI) in AP group was significantly lower than that in SS group. The length of hospitalization required for patients in AP group was significantly shorter than that in SS group.

    Conclusions: Total hospital costs for patients in AP group were significantly lower than for those in SS group. IIT using a closed-loop system maintained near-normoglycemia and contributed to a reduction in the incidence of SSI and total hospital costs due to shortened hospitalization.


      • Received November 24, 2008.
      • Accepted May 6, 2009.

    This Article

    1. Diabetes Care
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      1. dc08-2107v1
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