scholarly journals Tissue Response to Subcutaneous Infusion Catheter

2019 ◽  
Vol 14 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Ershuai Zhang ◽  
Zhiqiang Cao
Keyword(s):  
Insulin Infusion ◽  
Insulin Pump ◽  
System Development ◽  
Subcutaneous Tissue ◽  
Infusion Pump ◽  
Tissue Response ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Wear Time ◽  
Increased Risk

Insulin infusion pump, continuous glucose monitoring (CGM), and insulin infusion set (IIS) have been developed to be increasingly feasible for people with type 1 diabetes (T1D). Several recently approved CGMs are transitioning from 7-day to 10-day wear time without the need for fingerprick recalibration. Nevertheless, studies and improvements on IIS, a critical part of insulin pump therapy, have been limited. In particular, the recommended wear time of IIS is still 2-3 days, which can hardly match the current duration of CGM for potential closed-loop system development. It is generally believed that both the inserted catheter and the subsequent infused insulin drug could induce particular subcutaneous tissue response and skin-related complications at the infusion site. In certain cases, poor glycaemic control, increased risk of hypoglycemia, and serious cosmetic impact on people with diabetes were observed. Skin complication has also been attributed as an important factor resulting users to discontinue insulin pump therapy. This article provides the rare systematic review of IIS induced subcutaneous tissue responses and skin complications, including the impacts from the inserted catheters, the subcutaneous infused insulin, and the adhesive or tape used to immobilize the catheter. The FDA’s recommendation for the frequency of IIS change was further discussed. Future studies on this topic are required to further understand the IIS-related problems, and future strategies could be developed accordingly to significantly reduce the incidence of these problems, extend the wear time, and increase the acceptance of insulin pump based therapy.

Insulin Pump Therapy in the Very Low Birth Weight Infant

PEDIATRICS ◽  
1986 ◽  
Vol 78 (4) ◽  
pp. 625-630
Author(s):  
S. G. Ostertag ◽  
L. Jovanovic ◽  
B. Lewis ◽  
P. A. M. Auld
Keyword(s):  
Blood Glucose ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Insulin Infusion ◽  
Very Low Birth Weight ◽  
Insulin Pump ◽  
Infusion Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Continuous Insulin Infusion

Ten critically ill, very low birth weight infants less than 30 weeks' gestation were treated with exogenous insulin administered through a continuous insulin infusion pump (Betatron II, Cardiac Pacemaker, Inc). Infants were hyperglycemic to dextrose infusions greater than 6 mg/kg/min. The blood glucose concentration became normal in all infants within two to four hours, with varying requirements for continued insulin treatment. Tolerance to intravenous dextrose increased from a mean of 7.4 mg/kg/min to 11.2 mg/kg/min with aglycosuria. Energy intake increased from 49.5 calories/kg/d prior to insulin pump therapy to 70.4 calories/kg/d afterward (P < .01) with weight gain changed from –23 g/d to +13 g/d (P < .01). One unexpected observation was the apparent normalization of blood glucose homeostasis on higher dextrose doses among some infants after only one three- to six-hour treatment with insulin. The continuous insulin infusion pump is a flexible tool that allows insulin infusion rates to be changed as dictated by blood glucose values without altering other parenteral infusions.

Initiation and Management of Insulin Pump Therapy

1993 ◽  
Vol 19 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Suzanne M. Strowig
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Insulin Pump ◽  
Infusion Pump ◽  
Blood Glucose Control ◽  
Insulin Delivery ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Potential Risks

Insulin infusion pump therapy is a treatmertt option that facilitates achieving improved blood glucose control and lifestyle flexibility. These advantages are derived from the physiologic mode of insulin delivery and the pharmacologic advantages of using rapid-acting insulin. Patients who are sufficiently motivated and capable can learn to use the pump so that insulin adjustments can be made to compensate for changing circumstances. Although there are potential risks and side effects of using an insulin pump, these can be avoided through proper education and surveillance. The health care provider should be knowledgeable about the management of infusion pump therapy, including assessment of patient capabilities and practices, education, insulin adjustment, and techniques of use. The knowledge assists the health care provider in counseling patients to consider pump therapy and to manage patients already employing this mode of insulin delivery.

Cost-Effectiveness of Sensor-Augmented Insulin Pump Therapy Versus Continuous Insulin Infusion in Patients with Type 1 Diabetes in Turkey

2019 ◽  
Vol 21 (12) ◽  
pp. 727-735
Author(s):  
Stéphane Roze ◽  
Jayne Smith-Palmer ◽  
Simona de Portu ◽  
A. Zeynep Özdemir Saltik ◽  
Tuğba Akgül ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Insulin Infusion ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Continuous Insulin Infusion

Insulin Bolus Administration in Insulin Pump Therapy: Effect of Bolus Delivery Speed on Insulin Absorption from Subcutaneous Tissue

2019 ◽  
Vol 21 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Werner Regittnig ◽  
Martina Urschitz ◽  
Barbara Lehki ◽  
Michael Wolf ◽  
Harald Kojzar ◽  
...  
Keyword(s):  
Insulin Pump ◽  
Subcutaneous Tissue ◽  
Insulin Pump Therapy ◽  
Bolus Administration ◽  
Insulin Absorption ◽  
Pump Therapy ◽  
Therapy Effect

Numerical Simulation of Insulin Depot Formation in Subcutaneous Tissue Comparing Different Cannula Geometries

2016 ◽  
Author(s):  
Michael M. Zedelmair ◽  
Abhijit Mukherjee
Keyword(s):  
Insulin Pump ◽  
Subcutaneous Tissue ◽  
Skin Surface ◽  
Insulin Analogues ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Anisotropic Porous Media ◽  
Ansys Fluent ◽  
Sink Term ◽  
The Impact

In this study, the impact of the cannula geometry on the formation of the depot in subcutaneous tissue is investigated when injecting insulin using an insulin pump. The simulations have been conducted using the Computational Fluid Dynamics (CFD) software ANSYS Fluent. The study is focusing on rapid acting insulin analogues typically used in insulin pump therapy, which enter the bloodstream very shortly after administration. A previously developed 2-dimensional simulation has been transferred into a 3-dimensional case in order to simulate cases with non-axisymmetric geometries. The tissue has been modeled as a homogeneous anisotropic porous media by the use of different porosity values in the parallel and perpendicular direction with respect to the skin surface. The process of absorption is implemented into the model by the use of a locally variable species sink term. The basic case, simulated with a solid cannula, has been compared to other cannula geometries in order to evaluate if the delivery of insulin in the tissue can be improved. The geometries under consideration are the addition of circumferential holes in the wall of the cannula as well as using an array of cannulas instead of a single cannula. The depot formation is analyzed simulating a standard bolus injection of 0.05ml of insulin using an injection time of 25 seconds. It is observed that the addition of multiple holes in the wall of the cannula or using an array of cannulas can alter the shape of the depot quite significantly. The impact of the depot shape on the diffusion of insulin in the tissue has been evaluated by measuring the total volume of the depot after injection.

Continuous Subcutaneous Insulin Infusion (Insulin Pump) Therapy Can be Safely Used in the Hospital in Select Patients

2009 ◽  
Vol 15 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Rachel Bailon ◽  
Brenda Partlow ◽  
Victoria Miller-Cage ◽  
Mary Boyle ◽  
Janna Castro ◽  
...  
Keyword(s):  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Subcutaneous Insulin ◽  
Pump Therapy
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