One year of Hybrid Closed Loop on peritoneal dialysis: a case report

Abstract

Background: Automated insulin delivery is a game changer for type 1 diabetes treatment.

Objective: To describe the benefits of automated insulin delivery in a specific complex setting.

Methods: We are herein presenting a case of a patient with type 1 diabetes, in which Hybrid Closed Loop (Medtronic Minimed 670G on Auto Mode) was used over a year during automated peritoneal dialysis. The patient was previously on insulin therapy with sensor augmented pump and we switched him to Hybrid Closed Loop shortly before the begin of dialysis.

Results: Automated insulin delivery produced an increase of time in range (70-180 mg/dl) from 63% to 72%, after 3 months and to 74% after one year. Moreover, no hypoglycemia/hyperglycemia urgencies occurred overall during the year.

Conclusions: The case detailed here is the first report of Hybrid Closed Loop in a patient on automated peritoneal dialysis and it shows an improvement of time in range with a satisfying safety profile in a fragile, aged patient.

Keywords: Artificial pancreas; Automated insulin delivery; End stage renal failure; Peritoneal dialysis; Type 1 diabetes.