PMID- 27585938
OWN - NLM
STAT- MEDLINE
DCOM- 20170123
LR  - 20220409
IS  - 1432-5233 (Electronic)
IS  - 0940-5429 (Linking)
VI  - 53
IP  - 6
DP  - 2016 Dec
TI  - Insulin pump-associated adverse events are common, but not associated with 
      glycemic control, socio-economic status, or pump/infusion set type.
PG  - 991-998
LID - 10.1007/s00592-016-0897-2 [doi]
AB  - AIMS: While there have been many outcome-focussed studies examining insulin pump 
      therapy, only a few have looked at potential adverse events (AEs), with none 
      examining the relationship between AEs and pump/infusion set type, ethnicity or 
      socio-economic status. In addition, current data on the incidence and 
      characteristics of pump-associated AEs are confined to one paediatric centre. We 
      aimed to describe the incidence, characteristics and potential predictors of 
      insulin pump-associated AEs in New Zealand adults and children with T1DM. 
      METHODS: We approached adults and families of children with T1DM on insulin pumps 
      in four main New Zealand centres. Participants completed a questionnaire 
      examining pump-related issues they had experienced in the preceding 12 months. 
      RESULTS: Response rate was 64 % with 174 of 270 eligible people participating in 
      the study. 84 % of subjects reported one or more AEs, with an overall AE 
      incidence of 3.42 per person/year (95 % CI 3.14, 3.73). An event serious enough 
      to require a hospital presentation occurred in 9.8 %, all but one reporting high 
      ketones or diabetic ketoacidosis (DKA). Set/site problems were the AE most 
      commonly reported (by 53 % of respondents), followed by cutaneous complications 
      (43 %) and pump malfunction (38 %). Few predictors of AEs (of any type) were 
      found; however, a negative binomial regression model found that a longer duration 
      of pumping (p = 0.018) and age <18 years (p = 0.043) were both associated with 
      fewer AEs (all types combined). CONCLUSIONS: Insulin pump-associated AEs are very 
      common. However, few variables are predictive of them with no relationships seen 
      with glycaemic control, socio-economic status, pump manufacturer or infusion set 
      type. Based on these findings, AEs should be anticipated in both adults and 
      children, with anticipatory patient education and training recommended for their 
      successful and safe use.
FAU - Ross, P
AU  - Ross P
AD  - Department of Women's and Children's Health, University of Otago, PO Box 913, 
      Dunedin, 9054, New Zealand.
FAU - Gray, A R
AU  - Gray AR
AD  - Department of Preventive and Social Medicine, University of Otago, Dunedin, New 
      Zealand.
FAU - Milburn, J
AU  - Milburn J
AD  - Paediatric Endocrinology, Southern District Health Board, Dunedin, New Zealand.
FAU - Kumarasamy, I M
AU  - Kumarasamy IM
AD  - Diabetes Centre, Auckland District Health Board, Auckland, New Zealand.
FAU - Wu, F
AU  - Wu F
AD  - Diabetes Centre, Auckland District Health Board, Auckland, New Zealand.
FAU - Farrand, S
AU  - Farrand S
AD  - Department of Endocrinology, Southern District Health Board, Dunedin, New 
      Zealand.
FAU - Armishaw, J
AU  - Armishaw J
AD  - Department of Paediatrics, Tauranga Public Hospital, Tauranga, New Zealand.
FAU - Wiltshire, E
AU  - Wiltshire E
AD  - Department of Children's Health, University of Otago, Wellington, New Zealand.
FAU - Rayns, J
AU  - Rayns J
AD  - Paediatric Endocrinology, Southern District Health Board, Dunedin, New Zealand.
AD  - Department of Endocrinology, Southern District Health Board, Dunedin, New 
      Zealand.
FAU - Tomlinson, P
AU  - Tomlinson P
AD  - Department of Women's and Children's Health, University of Otago, PO Box 913, 
      Dunedin, 9054, New Zealand.
FAU - Wheeler, B J
AU  - Wheeler BJ
AD  - Department of Women's and Children's Health, University of Otago, PO Box 913, 
      Dunedin, 9054, New Zealand. ben.wheeler@otago.ac.nz.
AD  - Paediatric Endocrinology, Southern District Health Board, Dunedin, New Zealand. 
      ben.wheeler@otago.ac.nz.
LA  - eng
PT  - Journal Article
DEP - 20160901
PL  - Germany
TA  - Acta Diabetol
JT  - Acta diabetologica
JID - 9200299
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Blood Glucose/analysis
MH  - Child
MH  - *Diabetes Mellitus, Type 1/diagnosis/drug therapy/epidemiology
MH  - *Diabetic Ketoacidosis/epidemiology/etiology
MH  - Equipment Failure/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/adverse effects
MH  - Incidence
MH  - *Insulin/administration & dosage/adverse effects
MH  - *Insulin Infusion Systems/adverse effects/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - New Zealand/epidemiology
MH  - Social Class
MH  - Time Factors
OTO - NOTNLM
OT  - Adverse event
OT  - CSII
OT  - Insulin pump
OT  - Malfunction
OT  - Safety
EDAT- 2016/09/03 06:00
MHDA- 2017/01/24 06:00
CRDT- 2016/09/03 06:00
PHST- 2016/07/04 00:00 [received]
PHST- 2016/08/08 00:00 [accepted]
PHST- 2016/09/03 06:00 [pubmed]
PHST- 2017/01/24 06:00 [medline]
PHST- 2016/09/03 06:00 [entrez]
AID - 10.1007/s00592-016-0897-2 [pii]
AID - 10.1007/s00592-016-0897-2 [doi]
PST - ppublish
SO  - Acta Diabetol. 2016 Dec;53(6):991-998. doi: 10.1007/s00592-016-0897-2. Epub 2016 
      Sep 1.