BACKGROUND: Little is known about the frequencies and types of nonmetabolic complications occurring in type 1 diabetes patients being treated by modern insulin pump therapy (continuous subcutaneous insulin infusion [CSII]), when recorded by standardized questionnaire rather than clinical experience. SUBJECTS AND METHODS: A self-report questionnaire was completed by successive subjects with type 1 diabetes attending an insulin pump clinic, and those with a duration of CSII of ≥6 months were selected for analysis (n=92). Questions included pump manufacturer, insulin, infusion set type and duration of use, frequency of infusion set and site problems, pump malfunctions, and patient-related problems such as weight change since starting CSII. RESULTS: Median (range) duration of CSII was 3.3 (0.5-32.0) years, and mean ± SD duration of infusion set use was 3.2 ± 0.7 (range 2-6) days. The commonest infusion set problems were kinking (64.1% of subjects) and blockage (54.3%). Blockage was associated with >3 days of use of infusion sets plus lispro insulin in the pump (relative risk [95% confidence interval], 1.71 [1.03-2.85]; P=0.07). The commonest infusion site problem was lipohypertrophy (26.1%), which occurred more often in those with long duration of CSII (4.8 [2.38-9.45] vs. 3.0 [1.50-4.25] years; P=0.01). Pump malfunction had occurred in 48% of subjects (43% in the first year of CSII), with "no delivery," keypad, and battery problems commonly occurring. Although some patients reported weight gain (34%) and some weight loss (15%) on CSII, most patients (51%) reported no change in weight. CONCLUSIONS: Pump, infusion set, and infusion site problems remain common with CSII, even with contemporary technology.
BACKGROUND: Little is known about the frequencies and types of nonmetabolic complications occurring in type 1 diabetespatients being treated by modern insulin pump therapy (continuous subcutaneous insulin infusion [CSII]), when recorded by standardized questionnaire rather than clinical experience. SUBJECTS AND METHODS: A self-report questionnaire was completed by successive subjects with type 1 diabetes attending an insulin pump clinic, and those with a duration of CSII of ≥6 months were selected for analysis (n=92). Questions included pump manufacturer, insulin, infusion set type and duration of use, frequency of infusion set and site problems, pump malfunctions, and patient-related problems such as weight change since starting CSII. RESULTS: Median (range) duration of CSII was 3.3 (0.5-32.0) years, and mean ± SD duration of infusion set use was 3.2 ± 0.7 (range 2-6) days. The commonest infusion set problems were kinking (64.1% of subjects) and blockage (54.3%). Blockage was associated with >3 days of use of infusion sets plus lispro insulin in the pump (relative risk [95% confidence interval], 1.71 [1.03-2.85]; P=0.07). The commonest infusion site problem was lipohypertrophy (26.1%), which occurred more often in those with long duration of CSII (4.8 [2.38-9.45] vs. 3.0 [1.50-4.25] years; P=0.01). Pump malfunction had occurred in 48% of subjects (43% in the first year of CSII), with "no delivery," keypad, and battery problems commonly occurring. Although some patients reported weight gain (34%) and some weight loss (15%) on CSII, most patients (51%) reported no change in weight. CONCLUSIONS: Pump, infusion set, and infusion site problems remain common with CSII, even with contemporary technology.
Authors: D Bruttomesso; A Pianta; D Crazzolara; E Scaldaferri; L Lora; G Guarneri; A Mongillo; R Gennaro; M Miola; M Moretti; L Confortin; G P Beltramello; M Pais; A Baritussio; E Casiglia; A Tiengo Journal: Diabet Med Date: 2002-08 Impact factor: 4.359
Authors: Xuewei Wang; Aaron Jolliffe; Benjamin Carr; Qi Zhang; Mark Bilger; Yu Cui; Jianfeng Wu; Xianglong Wang; Mollie Mahoney; Alvaro Rojas-Pena; Mark J Hoenerhoff; Justin Douglas; Robert H Bartlett; Chuanwu Xi; Joseph L Bull; Mark E Meyerhoff Journal: Biomater Sci Date: 2018-11-20 Impact factor: 6.843