Last updated September 9, 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
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
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.
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.
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
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
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
Understand where this research contributes within the broader evidence network.
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.
This study contributes evidence to
Primary intervention
Full Closed Loop (FCL)
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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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.
1
Related topics
6
Evidence pairs
117
Related studies
Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Core evidence
The primary outcomes reported in this study.
Full Closed Loop (FCL) → Pre-meal mean glucose
Full Closed Loop (FCL) → Pre-meal mean glucose
Full Closed Loop (FCL) → Time in hypoglycemia (<3.0 mmol/L)
Full Closed Loop (FCL) → Time in hypoglycemia (<3.0 mmol/L)
Full Closed Loop (FCL) → Time to glycemic target
Full Closed Loop (FCL) → Time to glycemic target
Usual care → Time in hypoglycemia (<3.0 mmol/L)
Usual care → Time in hypoglycemia (<3.0 mmol/L)
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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).
This study contributes to the evidence on the following intervention-outcome relationships.
Devices & Technology
Devices & Technology
Curated evidence collections and hubs this study is part of.
All studies measuring CGM Time in Range
Measures CGM Time in Range as a key outcome.
All studies on Full Closed Loop (FCL)
Contributes to Full Closed Loop (FCL) evidence base.
All studies measuring Time in hypoglycemia (<3.0 mmol/L)
Measures Time in hypoglycemia (<3.0 mmol/L) as a key outcome.
Latest published studies
Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Full Closed Loop (FCL) appears to improve pre-meal mean glucose.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
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
Usual care appears to improve pre-meal mean glucose.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
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
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
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
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
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
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