Technological progress in the treatment of type 1 diabetes requires doctors to use modern methods of insulin therapy in all areas of medicine that patients may come into contact with, including surgical interventions. The current guidelines indicate the possibility of using continuous subcutaneous insulin infusion in minor surgical procedures, but there are few reported cases of using a hybrid closed-loop system in perioperative insulin therapy. This case presentation focuses on two children with type 1 diabetes who were treated with an advanced hybrid closed-loop (AHCL) system during a minor surgical procedure. In the periprocedural period, the recommended mean glycemia and the time in range were maintained.

With the rapid advancement of diabetes technology, the number of patients with type 1 diabetes (T1D) using automated insulin delivery (AID) systems is increasing, making the presence of such patients in the perioperative period more common. This study presents two cases of T1D patients who underwent thyroidectomy while using AID, following a protocol designed in collaboration with the diabetology, anesthesiology, and surgical teams. Two female patients, aged 12 and 33 years, both using AID systems, were admitted for elective thyroidectomy. Glycemic metrics prior to surgery indicated good glycemic control, leading to the decision to continue AID during the procedures. The use of AID enabled safe surgical performance with satisfactory glycemic control. In one case, a continuous glucose monitoring (CGM) sensor disruption likely resulted from acetaminophen distribution and/or sensor's proximity to the surgical field. This report highlights the need for standardized guidelines regarding the use of AID in the perioperative period.

Transient neonatal diabetes mellitus (TNDM) is a genetically heterogeneous form of neonatal diabetes characterized by hyperglycemia that remits during infancy with a tendency to recur in later life. This case report presents the history of a male infant with transient neonatal diabetes mellitus. The patient was treated with a continuous subcutaneous insulin infusion (CSII) and a continuous glucose monitoring (CGM) system until the age of 2 months, when the normoglycemia connected with a withdrawal of treatment was noted. The genetic test results excluded the majority of known mutations related to TNDM. This case report focuses on various genetic mutations and the clinical features connected with them that cause TNDM and highlights the difficulties in the diagnostic and therapeutic processes of this disease. CSII and CGM systems seem to be a safe and effective treatment option in TNDM and may be used in the therapy.