Resumen de Investigación
Analyzed using Evidence Intelligence™

Fully Closed-Loop Glucose Control Improves Glycemic Control in Surgery

Última actualización 9 de septiembre de 2026

Key finding

Mean percentage time with sensor glucose in target range was 80.1% ± 10.0% in the FCL group.

This study evaluated the efficacy and safety of a fully closed-loop glucose control system in major abdominal surgery, finding significant improvements in glucose management compared to usual care.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Short-Term (≤3 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

This study evaluated the efficacy and safety of a fully closed-loop glucose control system in major abdominal surgery, finding significant improvements in glucose management compared to usual care.

Clinical relevance

Effective glucose management is crucial during major surgeries, as it can reduce complications and improve recovery times. The findings suggest that implementing a fully closed-loop system could enhance patient safety and outcomes in surgical settings, particularly for those with diabetes.

Keep in mind

The study's sample size may limit the generalizability of findings. The trial was conducted in a specific surgical context, which may not apply to all settings. Potential confounding factors were not fully controlled.

Published in

Referencia de la Revista

Publication details and source links for this paper.

Gabija K, Arna MG, Christian AG, et al. Efficacy and Safety of Fully Closed-Loop Glucose Control in Major Abdominal Surgery: A Randomized Controlled Trial. Annals of Surgery. 2025;281(5):732-740. doi:10.1097/SLA.0000000000006549

Efectos Principales

FCL group had 80.1% ± 10.0% of time with sensor glucose in target range, compared to 53.7% ± 19.7% in UC (p=0.001).

Mean glucose was significantly lower in the FCL group at 7.5 ± 0.5 mmol/L versus 9.1 ± 2.4 mmol/L in UC (p=0.015).

Time in hypoglycemia (<3.0 mmol/L) was low in both groups, indicating safety of the interventions.

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Full Closed Loop (FCL), Usual care and Pre-meal mean glucose, Time in hypoglycemia (<3.0 mmol/L), Time to glycemic target.

Primary intervention

Full Closed Loop (FCL)

Primary outcomes

  • Pre-meal mean glucose
  • Time in hypoglycemia (<3.0 mmol/L)
  • Time to glycemic target

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

6
Evidence pairs
6
Relationships
1
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 63

1

Related topics

6

Evidence pairs

129

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 6 evidence relationships
  • Includes primary outcome data
  • Linked to 1 direct semantic evidence topic

Topic contributions

Evidence topic

Contributes evidence

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Evidencia principal

Tema de evidencia

CGM Time in Range

matched_outcome

Core evidence

Study findings

The primary outcomes reported in this study.

Pre-meal mean glucose

Full Closed Loop (FCL) → Pre-meal mean glucose

Full Closed Loop (FCL) → Pre-meal mean glucose

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Time in hypoglycemia (<3.0 mmol/L)

Full Closed Loop (FCL) → Time in hypoglycemia (<3.0 mmol/L)

Full Closed Loop (FCL) → Time in hypoglycemia (<3.0 mmol/L)

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Time to glycemic target

Full Closed Loop (FCL) → Time to glycemic target

Full Closed Loop (FCL) → Time to glycemic target

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Pre-meal mean glucose

Usual care → Pre-meal mean glucose

Usual care → Pre-meal mean glucose

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Time in hypoglycemia (<3.0 mmol/L)

Usual care → Time in hypoglycemia (<3.0 mmol/L)

Usual care → Time in hypoglycemia (<3.0 mmol/L)

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Time to glycemic target

Usual care → Time to glycemic target

Usual care → Time to glycemic target

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Evidence Library

Build your evidence library

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evidence suggest

La Evidencia Sugiere

  • FCL increased time in target glucose range by 26.4% compared to UC (p=0.001).
  • FCL reduced mean glucose levels by 1.6 mmol/L compared to UC (p=0.015).
  • Both groups had low time in hypoglycemia, indicating safety.
who this applies

A quién se aplica

  • Adults undergoing major abdominal surgery.
  • Patients with diabetes requiring glucose management during surgery.
keep in mind

Tener en Cuenta

  • Results may not be applicable to all types of surgeries.
  • Further research is needed to confirm findings in diverse populations.
  • The study did not assess long-term outcomes post-surgery.
between the lines

Entre Líneas

  • The study's sample size may limit the generalizability of findings.
  • The trial was conducted in a specific surgical context, which may not apply to all settings.
  • Potential confounding factors were not fully controlled.

Evidence Library

Build your evidence library

Save research, organize studies, and quickly find important evidence again.

Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Full Closed Loop (FCL) and CGM Time in Range, Full Closed Loop (FCL) and Time in hypoglycemia (<3.0 mmol/L).

Relaciones de evidencia relacionadas

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Full Closed Loop (FCL) improve pre-meal mean glucose?

Emerging Evidence

Full Closed Loop (FCL) appears to improve pre-meal mean glucose.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Pre-meal mean glucose

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

Does Usual care improve pre-meal mean glucose?

Emerging Evidence

Usual care appears to improve pre-meal mean glucose.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Pre-meal mean glucose

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

Does Full Closed Loop (FCL) affect time in hypoglycemia (<3.0 mmol/l)?

Emerging Evidence

Current evidence does not show a clear effect of Full Closed Loop (FCL) on time in hypoglycemia (<3.0 mmol/l).

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Time in hypoglycemia (<3.0 mmol/L)

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

Does Usual care affect time in hypoglycemia (<3.0 mmol/l)?

Emerging Evidence

Current evidence does not show a clear effect of Usual care on time in hypoglycemia (<3.0 mmol/l).

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Time in hypoglycemia (<3.0 mmol/L)

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
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