Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type
| Autor: | J Armishaw, Andrew R. Gray, I M Kumarasamy, F Wu, J Milburn, Stephanie Farrand, Jenny Rayns, Benjamin J Wheeler, Esko Wiltshire, Paul A Tomlinson, P Ross |
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| Předmět: |
Insulin pump
Adult Blood Glucose Male medicine.medical_specialty Time Factors Adolescent Infusion set Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Diabetic Ketoacidosis 03 medical and health sciences 0302 clinical medicine Endocrinology Insulin Infusion Systems Diabetes mellitus Internal Medicine Medicine Humans Hypoglycemic Agents Insulin 030212 general & internal medicine Adverse effect Child Socioeconomic status Glycemic business.industry Incidence (epidemiology) Incidence General Medicine Middle Aged medicine.disease Surgery Diabetes Mellitus Type 1 Social Class Emergency medicine Equipment Failure Female business New Zealand |
| Zdroj: | Europe PubMed Central |
| Popis: | 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.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.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 age18 years (p = 0.043) were both associated with fewer AEs (all types combined).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. |
| Databáze: | OpenAIRE |
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