Detection of insulin infusion site failure
Abstract:
Insulin infusion site (IIS) failures are a weakness in insulin pump therapy. We examined experience with IIS failures among US individuals with diabetes on insulin pump via survey distributed to the T1D Exchange Online Community. Demographic factors, IIS characteristics, and diabetes-related perceptions were assessed by logistic regression to determine odds of higher (≥1 per month) or lower (<1 per month) reported IIS failure frequency. IIS failures were common; 41.4% reported ≥1 per month. IIS failure is usually detected through development of hyperglycemia rather than pump alarm. No assessed demographic factor or IIS characteristic was predictive; however, higher odds of ≥1 failure per month was associated with feelings of burnout (OR 1.489 [1.024, 2.165]) and considering pump discontinuation (OR 2.233 [1.455, 3.427]). IIS failures are frequent and unpredictable, typically require hyperglycemia for detection, and are associated with negative perceptions. More should be done toward preventing IIS failures and/or detecting them sooner.
Reference:
Hughes MS, Douvas JL, Layfield-Bryan M, Blanco LE, Gray JC, Zapotoczny G, Espinoza J, Wilcox JH, Lal RA. Frequency and detection of insulin infusion site failure in the Type 1 Diabetes Exchange Online Community. Diabetes Technol Ther. 2023 Mar 1. doi: 10.1089/dia.2023.0005. Epub ahead of print. PMID: 36856574.