Procedures
RS, UC
The SC FCL system consisted of an Android smartphone, running the Cambridge adaptive model predictive control algorithm (version 0.3.71; HX variant) on the CamAPS HX mobile application (CamDiab Ltd., Cambridge, UK), an SC real-time continuous glucose monitoring (CGM) sensor (Dexcom G6; Dexcom, San Diego, CA), and the SC insulin pump (Dana Diabecare RS, Sooil, South Korea). The CamAPS HX app received CGM glucose values and communicated through Bluetooth with the pump, which modulated the SC delivery of faster acting insulin aspart (Fiasp; Novo Nordisk, Bagsværd, Denmark) every 8–12 min. The FCL insulin therapy was initialized upon hospital admission using the participants' body weight and estimated total daily insulin dose.The nominal glucose target was set to the default of 5.8 or 7.0 mmol/L, based on individual circumstances. Participants were treated with FCL insulin therapy until hospital discharge or a maximum of 20 days. The glucose levels (recorded through a masked Dexcom G6 CGM) of the UC group were managed by the clinical team in accordance with local guidelines. The study did not interfere or specify the perioperative care plans and activities. All study devices were managed by the study team.