Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Princeton University, Princeton, New Jersey, USA.
Diabetes Technol Ther. 2023 Jun;25(6):426-430. doi: 10.1089/dia.2023.0005. Epub 2023 Mar 20.
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.
胰岛素输注部位 (IIS) 故障是胰岛素泵治疗的一个弱点。我们通过向 T1D Exchange Online 社区分发调查，检查了美国使用胰岛素泵的糖尿病患者的 IIS 故障经验。通过逻辑回归评估人口统计学因素、IIS 特征和与糖尿病相关的认知，以确定更高（≥每月 1 次）或更低（<每月 1 次）报告的 IIS 故障频率的可能性。IIS 故障很常见；41.4%的人报告每月≥1 次。IIS 故障通常通过发生高血糖而不是泵报警来检测。没有评估的人口统计学因素或 IIS 特征具有预测性；然而，每月≥1 次故障的可能性与倦怠感（比值比 [OR] 1.489 [1.024, 2.165]）和考虑停用泵（OR 2.233 [1.455, 3.427]）相关。IIS 故障频繁且不可预测，通常需要高血糖才能检测到，并且与负面认知有关。应该采取更多措施预防 IIS 故障和/或更早地发现它们。
