A Case of Type 1 Diabetes in Which Artificial Endocrine Pancreas (STG-55) Was Used for Achieving the Favorable Perioperative Glycemic Control at the Third Partial Hepatectomy

Abstract

Perioperative glycemic control is important for the prevention of postoperative infection and complications, but tight glycemic control (TGC) tends to cause hypoglycemia. We used a closing loop artificial pancreas (AP; model STG-55; Nikkisou) in a patient with slowly progressive insulin-dependent diabetes mellitus (SPIDDM) undergoing hepatectomy a third time for recurrent colorectal metastases. The insulin dosage (24 h after the start of surgery) was 123 units at the third hepatectomy using the AP compared with 38 units at the first hepatectomy and 18 units at the second hepatectomy, as assessed using the conventional sliding scale method. In the present case, a large amount of insulin was injected, but the plasma glucose level was stable. The postoperative hospital stay was 11 days, which was the shortest period among similar previous cases. TGC using an AP enables us to achieve stable glycemic control without excessive hypoglycemia or hyperglycemia and to reduce the blood glucose variation. TGC using an AP was useful for perioperative blood glucose control in a patient with type 1 diabetes.