Afridi H, Olsen P, Levy N, Dhatariya K
Department of Anaesthesia and Pain Medicine West Suffolk Hospital NHS Trust Bury St. Edmunds Suffolk UK.
Department of Paediatric Diabetes West Suffolk Hospital NHS Trust Bury St. Edmunds Suffolk UK.
Anaesth Rep. 2025 Feb 19;13(1):e70003. doi: 10.1002/anr3.70003. eCollection 2025 Jan-Jun.
Management of type 1 diabetes is constantly evolving. Hybrid closed loop technology is replacing multiple dose insulin and continuous subcutaneous insulin infusions as the preferred manner for managing type 1 diabetes in the community. Currently, there are no case reports or clinical guidelines to instruct practitioners on the safe peri-operative use of hybrid closed loop technology for patients requiring emergency surgery. In our case report we present the case of a 15-year-old male patient who required emergency surgery and wanted to continue the benefits of his hybrid closed loop technology in managing his diabetes peri-operatively. In addition, we discuss the strategies we used to overcome the issue of the continuous glucose monitor misreading paracetamol as glucose. Finally, we present the rationale for the guidance of safe peri-operative use of hybrid closed loop technology. This may allow other patients to benefit from continuation of hybrid closed loop technology during emergency surgery.
1型糖尿病的管理方式在不断演变。混合闭环技术正在取代多次皮下注射胰岛素和持续皮下胰岛素输注,成为社区中管理1型糖尿病的首选方式。目前,尚无病例报告或临床指南指导从业者如何在急诊手术患者中安全地围手术期使用混合闭环技术。在我们的病例报告中,我们介绍了一名15岁男性患者的病例,该患者需要进行急诊手术,并希望在围手术期继续通过混合闭环技术控制糖尿病。此外,我们讨论了为克服连续血糖监测仪将对乙酰氨基酚误读为葡萄糖这一问题所采用的策略。最后,我们阐述了安全围手术期使用混合闭环技术的指导依据。这可能会让其他患者在急诊手术期间继续使用混合闭环技术并从中受益。