Insulin pump infusion set failure
Abstract:
Background: Although insulin pump infusion set failures are common, studies assessing the failure rate are limited.
Methods: Data were analyzed from two clinical trials in which 263 participants aged 6 to 71 years used 22,741 infusion sets. The frequency of removal due to prolonged hyperglycemia (CGM glucose >300 mg/dL immediately prior to removal and >250 mg/dL continuously for at least 2 hours prior to removal with at least 90 minutes >300 mg/dL out of the prior 120 minutes) was determined. Differences in failure rates among age groups and infusion set types were evaluated.
Results: Among 22,741 infusion sets, 748 (3.3%) were removed prior to 72 hours in association with prolonged hyperglycemia. The percentage replaced within 48 hours and within 24 hours with prolonged hyperglycemia were 1.8% and 1.0%, respectively. Mean duration of continuous time >250 mg/dL prior to removal was 5.1±3.7 hours. Using a less restrictive definition of failure related to hyperglycemia, 1688 (7.4%) sets were removed prior to 72 hours with a glucose level >300 mg/dL at the time of removal. The frequency of insulin set failure with prolonged hyperglycemia was lower in adults ≥18 years old (1.9%) than in those 14-17 years old (5.8%, P<0.001) or 6-13 years old (4.4%, P=0.002). The 90o Teflon sets had the highest frequency of prolonged hyperglycemia failure within 72 hours (4.0%) compared with the angled Teflon set frequency (1.3%, P=0.01) or the steel set frequency (1.9%, P=0.006).
Conclusions: Based on the data from these 22,741 infusion sets, infusion set changes associated with prolonged hyperglycemia occur on average about 4 times a year, with the frequency being higher in youth than adults. The frequency also appears to be higher with straight Teflon sets compared with angled Teflon sets and steel sets.
Reference:
Kanapka LG, Lum J, Beck RW. Insulin Pump Infusion Set Failures Associated with Prolonged Hyperglycemia: Frequency and Relationship to Age and Type of Infusion Set During 22,741 Infusion Set Wears. Diabetes Technol Ther. 2022 Feb 1. doi: 10.1089/dia.2021.0548. Epub ahead of print. PMID: 35104166.