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Clinical Trial
. 2013 Jul;15(7):575-9.
doi: 10.1089/dia.2013.0016. Epub 2013 May 7.

Patch pump versus conventional pump: postprandial glycemic excursions and the influence of wear time

Yoeri M Luijf  1 , Sabine Arnolds, Angelo Avogaro, Carsten Benesch, Daniela Bruttomesso, Anne Farret, Lutz Heinemann, Jerome Place, Eric Renard, Rachele Scotton, J Hans DeVries; AP@home consortium
Affiliations
Clinical Trial

Patch pump versus conventional pump: postprandial glycemic excursions and the influence of wear time

Yoeri M Luijf et al. Diabetes Technol Ther. 2013 Jul.

Abstract

Background and aims: The aim of this study was to compare blood glucose and plasma insulin profiles after bolus insulin infusion by a patch pump (PP) versus a conventional pump (CP), directly after placement and after Day 3 of use.

Patients and methods: Twenty patients with type 1 diabetes came in for two blocks of visits: one block of two visits while wearing the OmniPod® (Insulet Corp., Bedford, MA) insulin pump (PP) and one block of two visits while wearing the Medtronic Diabetes (Northridge, CA) Paradigm® pump (CP). Patients administered an identical mealtime insulin bolus of at least 6 IU.

Results: For PP, maximum glucose levels were 28.7% lower on Day 3 (P=0.020), when maximum insulin levels were 30.3% higher (P=0.002). For CP, maximum glucose levels were 26.5% lower on Day 3 (P=0.015), when maximum insulin levels were 46.4% higher (P=0.003). Glucose levels (mean [interquartile range]) were significantly lower on Day 3 for PP (168.2 [145.8] mg/dL vs. 139.4 [77.8] mg/dL; P=0.013), but not significantly so for CP (159.0 [66.1] mg/dL vs. 139.5 [57.9] mg/dL; P=0.084). Mean insulin levels were significantly higher on Day 3 for CP (195 [120] pmol/L vs. 230 [90] pmol/L; P=0.01), but not significantly so for PP (178 [106] pmol/L vs. 194 [120] pmol/L; P=0.099). There were no significant differences between the two catheter lengths.

Conclusions: Postprandial glycemic excursions were lower on Day 3 of catheter wear time, but there were no differences between PPs and CPs. These findings support the proposal that catheter wear time plays an important role in insulin absorption.

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Figures

FIG. 1.
FIG. 1.
(A) Patients completed two blocks of two visits, totaling four study visits to the clinical research center: two while wearing a conventional pump (CP) for insulin and two while wearing a patch pump (PP). The two visits (V1 and V2) within one block, in which the same pumps were used, were 48 h apart. Each visit took 5.5 h to complete. (B) Within each visit patients arrived at the clinical research center at 8:00 a.m. Blood samples for glucose and plasma insulin determination were collected every 15 min. The sampling rate was increased after the breakfast that was served to patients and continued until 4.5 h postprandially.
FIG. 2.
FIG. 2.
Mean postprandial glucose excursions for Day 1 and Day 3 of patch pump (PP) and catheter-based conventional pump (CP) use.
FIG. 3.
FIG. 3.
Mean postprandial insulin profiles for Day 1 and Day 3 of patch pump (PP) and catheter-based conventional pump (CP) use.
See this image and copyright information in PMC

References

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