Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion

Abstract Objective To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. Research design and methods This was a double-blind, randomized, crossover trial with...

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Published in:Journal of diabetes and its complications 2010-03, Vol.24 (2), p.73-78
Main Authors: Thethi, Tina K., MD, Rao, Ajay, MD, Kawji, Haytham, MD, Mallik, Tilak, Yau, C. Lillian, PhD, Christians, Uwe, MD, PhD, Fonseca, Vivian, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Blood Glucose - analysis
Cross-Over Studies
CSII
Deoxyglucose - blood
Diabetes
Diabetes Mellitus, Type 1 - drug therapy
Double-Blind Method
Endocrinology & Metabolism
F2-Isoprostanes - blood
Fasting - blood
Female
Glucose
Glycemic control
Humans
Hyperglycemia
Hyperglycemia - blood
Infusions, Subcutaneous - adverse effects
Infusions, Subcutaneous - instrumentation
Infusions, Subcutaneous - methods
Insulin
Insulin - administration & dosage
Insulin - analogs & derivatives
Insulin Infusion Systems
Insulin Lispro
Lysine - analogs & derivatives
Lysine - blood
Male
Middle Aged
Pump infusion line
Type 1 Diabetes
Young Adult
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cited_by cdi_FETCH-LOGICAL-c498t-d6200625a8f00899b3d4cb2ff153693fc98c41c46e0c5d32d9414baf8096c503
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container_end_page 78
container_issue 2
container_start_page 73
container_title Journal of diabetes and its complications
container_volume 24
creator Thethi, Tina K., MD
Rao, Ajay, MD
Kawji, Haytham, MD
Mallik, Tilak
Yau, C. Lillian, PhD
Christians, Uwe, MD, PhD
Fonseca, Vivian, MD
description Abstract Objective To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. Research design and methods This was a double-blind, randomized, crossover trial with 20 patients with diabetes mellitus I using insulins aspart and lispro without a line change for up to 100 h. Using retrospective continuous glucose monitoring, we analyzed the average glucose over the day. Changes in serum 1,5-anhydroglucitol, carboxymethyllysine, and free 15-F2t isoprostane were also studied. Results From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl ( P
doi_str_mv 10.1016/j.jdiacomp.2009.03.002
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Lillian, PhD ; Christians, Uwe, MD, PhD ; Fonseca, Vivian, MD</creator><creatorcontrib>Thethi, Tina K., MD ; Rao, Ajay, MD ; Kawji, Haytham, MD ; Mallik, Tilak ; Yau, C. Lillian, PhD ; Christians, Uwe, MD, PhD ; Fonseca, Vivian, MD</creatorcontrib><description>Abstract Objective To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. Research design and methods This was a double-blind, randomized, crossover trial with 20 patients with diabetes mellitus I using insulins aspart and lispro without a line change for up to 100 h. Using retrospective continuous glucose monitoring, we analyzed the average glucose over the day. Changes in serum 1,5-anhydroglucitol, carboxymethyllysine, and free 15-F2t isoprostane were also studied. Results From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl ( P &lt;.05), fasting glucose from 120.3 to 154.5 mg/dl ( P &lt;.05), postprandial glucose from 114.6 to 172.1 mg/dl ( P &lt;.05), and the daily maximum glucose from 207.7 to 242.8 dl ( P &lt;.05 for the trend). Time period that the glucose was &gt;180 mg/dl increased from 14.5% to 38.3% ( P &lt;.05). Loss of control occurred despite increase in total daily insulin dose from 48.5±11.8 to 55.3±17.9 U ( P =.05). There was no difference in loss of control between insulin types, and biomarkers measured did not change significantly. Conclusions The insulin pump infusion should be changed every 48 h in patients using continuous subcutaneous insulin infusion (CSII), to avoid loss of glycemic control. In the short-term, this loss of glycemic control has no impact on oxidative stress and glycation.</description><identifier>ISSN: 1056-8727</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2009.03.002</identifier><identifier>PMID: 19395280</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Blood Glucose - analysis ; Cross-Over Studies ; CSII ; Deoxyglucose - blood ; Diabetes ; Diabetes Mellitus, Type 1 - drug therapy ; Double-Blind Method ; Endocrinology &amp; Metabolism ; F2-Isoprostanes - blood ; Fasting - blood ; Female ; Glucose ; Glycemic control ; Humans ; Hyperglycemia ; Hyperglycemia - blood ; Infusions, Subcutaneous - adverse effects ; Infusions, Subcutaneous - instrumentation ; Infusions, Subcutaneous - methods ; Insulin ; Insulin - administration &amp; dosage ; Insulin - analogs &amp; derivatives ; Insulin Infusion Systems ; Insulin Lispro ; Lysine - analogs &amp; derivatives ; Lysine - blood ; Male ; Middle Aged ; Pump infusion line ; Type 1 Diabetes ; Young Adult</subject><ispartof>Journal of diabetes and its complications, 2010-03, Vol.24 (2), p.73-78</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-d6200625a8f00899b3d4cb2ff153693fc98c41c46e0c5d32d9414baf8096c503</citedby><cites>FETCH-LOGICAL-c498t-d6200625a8f00899b3d4cb2ff153693fc98c41c46e0c5d32d9414baf8096c503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19395280$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thethi, Tina K., MD</creatorcontrib><creatorcontrib>Rao, Ajay, MD</creatorcontrib><creatorcontrib>Kawji, Haytham, MD</creatorcontrib><creatorcontrib>Mallik, Tilak</creatorcontrib><creatorcontrib>Yau, C. Lillian, PhD</creatorcontrib><creatorcontrib>Christians, Uwe, MD, PhD</creatorcontrib><creatorcontrib>Fonseca, Vivian, MD</creatorcontrib><title>Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion</title><title>Journal of diabetes and its complications</title><addtitle>J Diabetes Complications</addtitle><description>Abstract Objective To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. Research design and methods This was a double-blind, randomized, crossover trial with 20 patients with diabetes mellitus I using insulins aspart and lispro without a line change for up to 100 h. Using retrospective continuous glucose monitoring, we analyzed the average glucose over the day. Changes in serum 1,5-anhydroglucitol, carboxymethyllysine, and free 15-F2t isoprostane were also studied. Results From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl ( P &lt;.05), fasting glucose from 120.3 to 154.5 mg/dl ( P &lt;.05), postprandial glucose from 114.6 to 172.1 mg/dl ( P &lt;.05), and the daily maximum glucose from 207.7 to 242.8 dl ( P &lt;.05 for the trend). Time period that the glucose was &gt;180 mg/dl increased from 14.5% to 38.3% ( P &lt;.05). Loss of control occurred despite increase in total daily insulin dose from 48.5±11.8 to 55.3±17.9 U ( P =.05). There was no difference in loss of control between insulin types, and biomarkers measured did not change significantly. Conclusions The insulin pump infusion should be changed every 48 h in patients using continuous subcutaneous insulin infusion (CSII), to avoid loss of glycemic control. 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Lillian, PhD</au><au>Christians, Uwe, MD, PhD</au><au>Fonseca, Vivian, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion</atitle><jtitle>Journal of diabetes and its complications</jtitle><addtitle>J Diabetes Complications</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>24</volume><issue>2</issue><spage>73</spage><epage>78</epage><pages>73-78</pages><issn>1056-8727</issn><eissn>1873-460X</eissn><abstract>Abstract Objective To systematically investigate the effect of lack of adherence to the recommended change in insulin pump infusion line use beyond 48 h and determine whether the type of insulin made a difference. Research design and methods This was a double-blind, randomized, crossover trial with 20 patients with diabetes mellitus I using insulins aspart and lispro without a line change for up to 100 h. Using retrospective continuous glucose monitoring, we analyzed the average glucose over the day. Changes in serum 1,5-anhydroglucitol, carboxymethyllysine, and free 15-F2t isoprostane were also studied. Results From Day 2 to Day 5 of the pump line use, the daily average glucose level increased from 122.7 to 163.9 mg/dl ( P &lt;.05), fasting glucose from 120.3 to 154.5 mg/dl ( P &lt;.05), postprandial glucose from 114.6 to 172.1 mg/dl ( P &lt;.05), and the daily maximum glucose from 207.7 to 242.8 dl ( P &lt;.05 for the trend). Time period that the glucose was &gt;180 mg/dl increased from 14.5% to 38.3% ( P &lt;.05). Loss of control occurred despite increase in total daily insulin dose from 48.5±11.8 to 55.3±17.9 U ( P =.05). There was no difference in loss of control between insulin types, and biomarkers measured did not change significantly. Conclusions The insulin pump infusion should be changed every 48 h in patients using continuous subcutaneous insulin infusion (CSII), to avoid loss of glycemic control. In the short-term, this loss of glycemic control has no impact on oxidative stress and glycation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19395280</pmid><doi>10.1016/j.jdiacomp.2009.03.002</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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ispartof Journal of diabetes and its complications, 2010-03, Vol.24 (2), p.73-78
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1873-460X
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source ScienceDirect Journals
subjects Adolescent
Adult
Aged
Blood Glucose - analysis
Cross-Over Studies
CSII
Deoxyglucose - blood
Diabetes
Diabetes Mellitus, Type 1 - drug therapy
Double-Blind Method
Endocrinology & Metabolism
F2-Isoprostanes - blood
Fasting - blood
Female
Glucose
Glycemic control
Humans
Hyperglycemia
Hyperglycemia - blood
Infusions, Subcutaneous - adverse effects
Infusions, Subcutaneous - instrumentation
Infusions, Subcutaneous - methods
Insulin
Insulin - administration & dosage
Insulin - analogs & derivatives
Insulin Infusion Systems
Insulin Lispro
Lysine - analogs & derivatives
Lysine - blood
Male
Middle Aged
Pump infusion line
Type 1 Diabetes
Young Adult
title Consequences of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion
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