Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 2551-2556 |
| Number of pages | 6 |
| Journal | Diabetes, Obesity and Metabolism |
| Volume | 20 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2018 |
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Insulin pump breakdown and infusion set failure in Italian children with type 1 diabetes: A 1-year prospective observational study with suggestions to minimize clinical impact. / Rabbone, Ivana; Minuto, N; Toni, Sonia; Lombardo, F; Iafusco, Dario; Marigliano, Marco; Schiaffini, R; Maltoni, Giulio; Frongia, AP; Scardapane, M; Nicolucci, A; Cherubini, Valentino; Bonfanti, R; Scaramuzza, Andrea E; (ISPED), the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology.
In: Diabetes, Obesity and Metabolism, Vol. 20, No. 11, 2018, p. 2551-2556.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Insulin pump breakdown and infusion set failure in Italian children with type 1 diabetes: A 1-year prospective observational study with suggestions to minimize clinical impact
AU - Rabbone, Ivana
AU - Minuto, N
AU - Toni, Sonia
AU - Lombardo, F
AU - Iafusco, Dario
AU - Marigliano, Marco
AU - Schiaffini, R
AU - Maltoni, Giulio
AU - Frongia, AP
AU - Scardapane, M
AU - Nicolucci, A
AU - Cherubini, Valentino
AU - Bonfanti, R
AU - Scaramuzza, Andrea E
AU - (ISPED), the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology
PY - 2018
Y1 - 2018
N2 - Aim: To evaluate the incidence of insulin pump and infusion set failures in a cohort of children and adolescents with type 1 diabetes during a 1-year follow-up. Materials and Methods: Insulin pump breakdown and infusion set failures were prospectively registered in a cohort of 1046 children and adolescents from 25 tertiary pediatric diabetes centres (50% male, mean age 12.2 ± 4.1 years), with type 1 diabetes from the age of 6.7 ± 3.6 years, and using an insulin pump from the age of 3.3 ± 2.2 years. Results: An average rate of 4.5 failures/person-year was registered; the incidences (events per person-year) for each failure were 8.4 for hyperglycaemia episodes solved with infusion set change, 7 for bubbles, 2.8 for kinking, 2.4 for bleeding, 2 for set dislodge, 2 for pump blockage, 1.9 for tunnelling, 1.8 for lipohypertrophy, and 0.3 for infection. At multivariate analysis significant association between HbA1c and lipohypertrophy (P <0.0028) was shown. Analysis by age group (11 years) showed a higher frequency of bubbles, hyperglycaemia episodes and lipohypertrophy in preschoolers; tunnelling and pump blockage were more frequent in adolescents. Aspart was associated with a lower risk of bubbles and hyperglycaemia whereas glulisine was associated with a higher risk of lipohypertrophy and pump blockage. The usage of oblique cannula was associated with a low risk of all failures except infections. Conclusions: This prospective 1-year study on a large cohort of Italian children and adolescents with type 1 diabetes using insulin pump therapy showed a low total failure rate, highlighting the importance of continuous education to reduce failures. Lipohypertrophy was the only issue associated with a worsening of metabolic control. © 2018 John Wiley & Sons Ltd.
AB - Aim: To evaluate the incidence of insulin pump and infusion set failures in a cohort of children and adolescents with type 1 diabetes during a 1-year follow-up. Materials and Methods: Insulin pump breakdown and infusion set failures were prospectively registered in a cohort of 1046 children and adolescents from 25 tertiary pediatric diabetes centres (50% male, mean age 12.2 ± 4.1 years), with type 1 diabetes from the age of 6.7 ± 3.6 years, and using an insulin pump from the age of 3.3 ± 2.2 years. Results: An average rate of 4.5 failures/person-year was registered; the incidences (events per person-year) for each failure were 8.4 for hyperglycaemia episodes solved with infusion set change, 7 for bubbles, 2.8 for kinking, 2.4 for bleeding, 2 for set dislodge, 2 for pump blockage, 1.9 for tunnelling, 1.8 for lipohypertrophy, and 0.3 for infection. At multivariate analysis significant association between HbA1c and lipohypertrophy (P <0.0028) was shown. Analysis by age group (11 years) showed a higher frequency of bubbles, hyperglycaemia episodes and lipohypertrophy in preschoolers; tunnelling and pump blockage were more frequent in adolescents. Aspart was associated with a lower risk of bubbles and hyperglycaemia whereas glulisine was associated with a higher risk of lipohypertrophy and pump blockage. The usage of oblique cannula was associated with a low risk of all failures except infections. Conclusions: This prospective 1-year study on a large cohort of Italian children and adolescents with type 1 diabetes using insulin pump therapy showed a low total failure rate, highlighting the importance of continuous education to reduce failures. Lipohypertrophy was the only issue associated with a worsening of metabolic control. © 2018 John Wiley & Sons Ltd.
U2 - 10.1111/dom.13419
DO - 10.1111/dom.13419
M3 - Article
VL - 20
SP - 2551
EP - 2556
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
SN - 1462-8902
IS - 11
ER -