Insulin Infusion Set Use: European Perspectives and Recommendations
Open accessAbstract
Insulin pump users worldwide depend on insulin infusion sets (IISs) for predictable delivery of insulin to the subcutaneous tissue. Yet emerging data indicates that IISs are associated with many pump-related adverse events and may contribute to potentially life-threatening problem of unexplained hyperglycemia. The relative scarcity of published research on IISs to date, the heterogeneity of regional IIS practices, and the increasing demand for international standards guiding their use prompted convening of a panel of diabetologists and diabetes nurse educators last February, in Milan, Italy, to discuss a framework for optimizing IIS practice in Europe. The multinational panel was tasked, first, with identifying the often-overlooked IIS issues that can affect patients' experience of pump therapy—e.g., partial or complete blockage of the cannula, skin pathologies, unpredictable variations in insulin absorption, dislodgment, and the demands of site rotation and set changes—and, second, with establishing direction for developing cohesive protocols to assure long-term success. As reported in this article, the panel examined IIS-related complications of pump therapy encountered in clinical practice, considered country-wide policies to prevent and mitigate such complications, and updated priorities for improving IIS education on issues of device selection, skin care, and troubleshooting unexplained hyperglycemia. These recommendations may be more relevant with the possibility of closed-loop systems available in the near future.
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Despite recent improvements in CSII catheter design and insertion method, the CSII catheter remains the weak link of an insulin infusion system for the management of type 1 diabetes.
“Despite recent improvements in CSII catheter design and method of insertion, the CSII catheter remains the weak link of an insulin infusion system for the management of type 1 diabetes.”
From Detailed Analysis of Insulin Absorption Variability and the Tissue Response to Continuous Subcutaneous Insulin Infusion Catheter Implantation in Swine (2017) · cites this paper as [7]
The Abstract and Conclusion describe infusion sets as essential to pump therapy and implicated in many pump-related adverse events, supporting the claim that the catheter remains a vulnerable component. The Conclusion discusses a newer cannula design, but the passages on insertion in “Site Selection and Rotation” describe available techniques rather than establishing that insertion methods have recently improved. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSFs may be caused by catheter kinking, insulin precipitation, insulin leakage, site inflammation, set detachment, or otherwise unknown reasons and lead to hyperglycemia and ketonemia if left uncorrected.
“SFs may be caused by catheter kinking, insulin precipitation, insulin leakage, site inflammation, set detachment, or otherwise unknown reasons and lead to hyperglycemia and ketonemia if left uncorrected.”
From Real-Time Detection of Infusion Site Failures in a Closed-Loop Artificial Pancreas (2018) · cites this paper as [16]
It is currently recommended that insulin infusion sets are changed every two to three days.
“It is currently recommended that insulin infusion sets are changed every two to three days, 16,28”
From Real-Time Detection of Infusion Site Failures in a Closed-Loop Artificial Pancreas (2018) · cites this paper as [16]
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- Authors
- Deiss, D., Adolfsson, P., Alkemade-van Zomeren, M., Bolli, G. B., Charpentier, G., Cobelli, C., Danne, T., Girelli, A., Mueller, H., Verderese, C. A., & Renard, E.
- Affiliations
- Medicover (DE)
- University of Gothenburg (SE)
- Maasstad Hospital
- University of Perugia (IT)
- Centre Hospitalier Sud Francilien (FR)
- University of Padua (IT)
- Kinderkrankenhaus auf der Bult (DE)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Deutsche Klinik für Diagnostik (DE)
- The Diabetes Education Group
- University of Montpellier
- Corresponding author
- Deiss, Dorothee
- ORCID
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2016-09
- Volume
- 18
- Issue
- 9
- Pages
- 517-524
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- PMC
- PMC5040072
- OpenAlex
- W2508333270
- Cited by
- 62
- References
- 24
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 11 · 2023: 6 · 2022: 8 · 2021: 1 · 2020: 2 · 2019: 11 · 2018: 12 · 2017: 7 · 2016: 1
- FWCI
- 10.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Technology & Therapeutics (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Eli Lilly and Company
- AstraZeneca
- Sanofi
- Insulet Corporation
- Dexcom
- Bayer HealthCare
- Università degli Studi di Padova
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Physical Sciences › Engineering › Biomedical Engineering › Intravenous Infusion Technology and Safety
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- insulin pump therapy, skin care, equipment troubleshooting, diabetes education, artificial pancreas
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 1, Europe, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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