OBJECTIVE: To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. RESEARCH DESIGN AND METHODS: This was a double-blind, randomized, crossover trial with 20 patients with diabetes mellitus I using insulins aspart and lispro without a line change for up to 100 h. Using retrospective continuous glucose monitoring, we analyzed the average glucose over the day. Changes in serum 1,5-anhydroglucitol, carboxymethyllysine, and free 15-F(2t) isoprostane were also studied. RESULTS: From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl (P<.05), fasting glucose from 120.3 to 154.5 mg/dl (P<.05), postprandial glucose from 114.6 to 172.1 mg/dl (P<.05), and the daily maximum glucose from 207.7 to 242.8 dl (P<.05 for the trend). Time period that the glucose was >180 mg/dl increased from 14.5% to 38.3% (P<.05). Loss of control occurred despite increase in total daily insulin dose from 48.5+/-11.8 to 55.3+/-17.9 U (P=.05). There was no difference in loss of control between insulin types, and biomarkers measured did not change significantly. CONCLUSIONS: The insulin pump infusion should be changed every 48 h in patients using continuous subcutaneous insulin infusion (CSII), to avoid loss of glycemic control. In the short-term, this loss of glycemic control has no impact on oxidative stress and glycation.
RCT Entities:
OBJECTIVE: To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. RESEARCH DESIGN AND METHODS: This was a double-blind, randomized, crossover trial with 20 patients with diabetes mellitus I using insulins aspart and lispro without a line change for up to 100 h. Using retrospective continuous glucose monitoring, we analyzed the average glucose over the day. Changes in serum 1,5-anhydroglucitol, carboxymethyllysine, and free 15-F(2t) isoprostane were also studied. RESULTS: From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl (P<.05), fasting glucose from 120.3 to 154.5 mg/dl (P<.05), postprandial glucose from 114.6 to 172.1 mg/dl (P<.05), and the daily maximum glucose from 207.7 to 242.8 dl (P<.05 for the trend). Time period that the glucose was >180 mg/dl increased from 14.5% to 38.3% (P<.05). Loss of control occurred despite increase in total daily insulin dose from 48.5+/-11.8 to 55.3+/-17.9 U (P=.05). There was no difference in loss of control between insulin types, and biomarkers measured did not change significantly. CONCLUSIONS: The insulin pump infusion should be changed every 48 h in patients using continuous subcutaneous insulin infusion (CSII), to avoid loss of glycemic control. In the short-term, this loss of glycemic control has no impact on oxidative stress and glycation.
Authors: Irl B Hirsch; Bruce W Bode; Satish Garg; Wendy S Lane; Allen Sussman; Peter Hu; Olga M Santiago; Jerzy W Kolaczynski Journal: Diabetes Care Date: 2005-03 Impact factor: 19.112
Authors: M Rosilio; J B Cotton; M C Wieliczko; B Gendrault; J C Carel; O Couvaras; N Ser; P Gillet; S Soskin; P Garandeau; C Stuckens; B Le Luyer; J Jos; H Bony-Trifunovic; A M Bertrand; F Leturcq; A Lafuma; P F Bougnères Journal: Diabetes Care Date: 1998-07 Impact factor: 19.112
Authors: Parul J Patel; Kari Benasi; Gina Ferrari; Mark G Evans; Satya Shanmugham; Darrell M Wilson; Bruce A Buckingham Journal: Diabetes Technol Ther Date: 2013-10-03 Impact factor: 6.118
Authors: Andrew W Karlin; Trang T Ly; Laura Pyle; Gregory P Forlenza; Laurel Messer; R Paul Wadwa; Daniel J DeSalvo; Sydney L Payne; Sarah Hanes; Paula Clinton; David M Maahs; Bruce Buckingham Journal: Diabetes Technol Ther Date: 2016-05-26 Impact factor: 6.118