Freckmann Guido, Kamecke Ulrike, Waldenmaier Delia, Haug Cornelia, Ziegler Ralph
1 Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany.
2 Diabetes Clinic for Children and Adolescents, Muenster, Germany.
J Diabetes Sci Technol. 2018 May;12(3):608-613. doi: 10.1177/1932296817750404. Epub 2017 Dec 29.
The detection of insulin infusion set (IIS) occlusions is an important feature of insulin pumps with regard to patient safety. However, there are no requirements for a time limit until an alarm has to be triggered after an occlusion occurred. The standard IEC 60601-2-24 is applicable for insulin pumps and describes test settings and procedures to determine occlusion detection time (ODT).
In this study, ODT of six different insulin pump models with different IIS (in total 10 different insulin pump systems) was tested for two basal rates (1.0 U/h and 0.1 U/h).
Differences were seen between the tested pump systems. At a basal rate of 1.0 U/h all insulin pump systems showed an acceptable ODT of less than 5 hours. However, at a basal rate of 0.1 U/h, as often used in children, the median ODT ranged from approximately 4 hours to more than 40 hours. With the lower basal rate, median ODT was longer than 6-8 hours for 9 of the 10 systems.
Insulin pump users should not blindly rely on occlusion alarms but perform regular glucose monitoring and manufacturers should develop mechanisms that allow an earlier detection at low basal rates.
胰岛素输注装置(IIS)堵塞的检测对于胰岛素泵的患者安全而言是一项重要功能。然而,对于堵塞发生后触发警报的时间限制并无相关要求。标准IEC 60601-2-24适用于胰岛素泵,并描述了确定堵塞检测时间(ODT)的测试设置和程序。
在本研究中,针对两种基础输注速率(1.0 U/h和0.1 U/h)测试了六种配备不同IIS的不同胰岛素泵型号(总共10种不同的胰岛素泵系统)的ODT。
在所测试的泵系统之间存在差异。在基础输注速率为1.0 U/h时,所有胰岛素泵系统的ODT均小于5小时,处于可接受范围。然而,在儿童常用的基础输注速率0.1 U/h时,ODT中位数范围约为4小时至超过40小时。基础输注速率较低时,10个系统中有9个系统的ODT中位数超过6 - 8小时。
胰岛素泵使用者不应盲目依赖堵塞警报,而应定期进行血糖监测,并且制造商应开发能够在低基础输注速率下更早检测堵塞的机制。