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

Ivana Rabbone, N Minuto, Sonia Toni, F Lombardo, Dario Iafusco, Marco Marigliano, R Schiaffini, Giulio Maltoni, AP Frongia, M Scardapane, A Nicolucci, Valentino Cherubini, R Bonfanti, Andrea E Scaramuzza, the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED)

Research output: Contribution to journalArticle

Abstract

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.
Original languageEnglish
Pages (from-to)2551-2556
Number of pages6
JournalDiabetes, Obesity and Metabolism
Volume20
Issue number11
DOIs
Publication statusPublished - 2018

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Infusion Pumps
Type 1 Diabetes Mellitus
Observational Studies
Hyperglycemia
Prospective Studies
Insulin
Incidence
Infection
Nuclear Family
Multivariate Analysis
Age Groups
Pediatrics
Hemorrhage
Education
Therapeutics

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Rabbone, I., Minuto, N., Toni, S., Lombardo, F., Iafusco, D., Marigliano, M., ... (ISPED), T. D. S. G. O. T. I. S. O. P. E. A. D. (2018). 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. Diabetes, Obesity and Metabolism, 20(11), 2551-2556. https://doi.org/10.1111/dom.13419

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 journalArticle

Rabbone, I, Minuto, N, Toni, S, Lombardo, F, Iafusco, D, Marigliano, M, Schiaffini, R, Maltoni, G, Frongia, AP, Scardapane, M, Nicolucci, A, Cherubini, V, Bonfanti, R, Scaramuzza, AE & (ISPED), TDSGOTISOPEAD 2018, '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', Diabetes, Obesity and Metabolism, vol. 20, no. 11, pp. 2551-2556. https://doi.org/10.1111/dom.13419
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. / 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. In: Diabetes, Obesity and Metabolism. 2018 ; Vol. 20, No. 11. pp. 2551-2556.
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abstract = "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. {\circledC} 2018 John Wiley & Sons Ltd.",
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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 -