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Aim: To assess the feasibility of a prototype insulin infusion set (IIS) for extended wear in adults with type 1 diabetes. Materials and Methods: The prototype Capillary Biomedical investigational extended‐wear IIS (CBX IIS) incorporates a soft, flexible, reinforced kink‐resistant angled nylon‐derivative cannula with one distal and three proximal ports to optimize insulin delivery. Twenty adult participants with type 1 diabetes established on insulin pump therapy used the CBX IIS for two 7‐day test periods while wearing a Dexcom G5 continuous glucose monitor. Results: Participants were able to wear the CBX IIS for an average of 6.6 ± 1.4 days. Eighty‐eight percent (36 of 41) of sets were worn for 7 days. No serious adverse events were reported. Five infusion sets failed prematurely because of: unresolvable hyperglycaemia (three); hyperglycaemia with elevated ketones (one); or infection (one). Median time in range (3.9‐10.0 mmol/L) was 62% (54‐76). Average glucose levels per day of infusion set wear showed a statistically significant increase over time (p <.001). Conclusions: Our preliminary observations confirm the tolerability of the prototype CBX IIS for extended wear, albeit with a deterioration in glucose control after the third day. [ABSTRACT FROM AUTHOR]

The automated insulin delivery systems show great promise to maintain the patient's BG concentration in the target range while eliminating the risk for hypoglycemia, especially when the clinical situation is changing rapidly in the operative room or ICU. We believe that using blood glucose value as the sixth vital sign and the implementation of continuous glucose monitoring systems (CGM or glucose sensors) in the hospital setting would significantly improve perioperative glycemic control. Insulin was not started until 9 am when his BG was 30.5 mmol/l. This emphasizes the importance of glucose control even in patients who are not diagnosed as having diabetes. [Extracted from the article]