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. 2023 Jun;25(6):426-430.
doi: 10.1089/dia.2023.0005. Epub 2023 Mar 20.

Frequency and Detection of Insulin Infusion Site Failure in the Type 1 Diabetes Exchange Online Community

Michael S Hughes  1 , Julia L Douvas  2 , Madison Layfield-Bryan  3 , Luis E Blanco  3 , John Clark Gray  3 , Grzegorz Zapotoczny  4 , Juan Espinoza  4 , John H Wilcox  3 , Rayhan A Lal  1   5
Affiliations

Frequency and Detection of Insulin Infusion Site Failure in the Type 1 Diabetes Exchange Online Community

Michael S Hughes et al. Diabetes Technol Ther. 2023 Jun.

Abstract

Insulin infusion site (IIS) failures are a weakness in insulin pump therapy. We examined experience with IIS failures among U.S. individuals with diabetes on insulin pump through 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 were associated with feelings of burnout (odds ratios [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.

Keywords: Failure; Insulin infusion set; Insulin infusion site; Insulin pump; Pump malfunction.

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Conflict of interest statement

M.S.H. has consulted for Dexcom, Inc. R.A.L. has consulted for Abbott Diabetes Care, Biolinq, Capillary Biomedical, Deep Valley Labs, Morgan Stanley, Gluroo, and Tidepool. L.E.B., J.C.G., and J.H.W. are employees at Diatech Diabetes, Inc. M.L.-B. was an employee/intern at Diatech Diabetes, Inc. J.L.D., G.Z., and J.E. have no relevant disclosures.

Figures

FIG. 1.
FIG. 1.
Participants' self-reported frequencies of IIS failure. Depicts survey results from self-estimated IIS failure frequencies. The most selected answer was “Rarely (Once every 2–6 months)”; however, a frequency of IIS failure ≥1 per month was selected by 41.4% of the cohort. IIS, insulin infusion site.
See this image and copyright information in PMC

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