Quantifying the Impact of a Short-Interval Interruption of Insulin-Pump Infusion Sets on Glycemic Excursions
Open accessAbstract
This prospective, open-label study was designed to measure the impact of short-term infusion-set disconnects on glucose levels. Continuous subcutaneous insulin infusion therapy allows for uninterrupted delivery of insulin. Patients disconnect their insulin pumps from their infusion sets when showering, swimming, exercising, or during intimate moments. Interrupting insulin infusion results in cessation of basal insulin delivery. Nineteen subjects with type 1 diabetes were studied on two separate in-clinic days. One hour after arriving at the clinic in a fasting state, subjects either temporarily disconnected their infusion sets from their pumps, interrupting basal insulin infusion for 30 min, or, on a separate day, changed their infusion sets. Glucose levels were monitored for an additional 4 h on both occasions. Changing infusion sets did not affect short-term glucose control. However, the 30-min interruption of basal insulin infusion resulted in significant glucose elevation; ∼1 mg/dl for each minute basal insulin infusion was interrupted.
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In a study of five brands of insulin pumps, the time from occlusion to alarm ranged from 1.5 hours to 24 hours, with most combinations in the range of 2-4 hours.
“The time from occlusion to alarm ranged from 1.5 hours to 24 hours; most combinations were in the range of 2-4 hours.”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [11]
The Research Design and Methods section describes a 30-minute pump disconnection study involving three pump makes, not a measurement of occlusion-to-alarm times. Searches for occlusion alarms and the claimed 1.5–24-hour and 2–4-hour ranges found no passage addressing those figures in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThe time from occlusion to alarm was approximately double for an infusion rate of 0.5 U/hour than with an infusion rate of 1.0 U/hour.
“The time from occlusion to alarm was approximately double for an infusion rate of 0.5 U/hour than with an infusion rate of 1.0 U/hour.11”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [11]
The Research Design and Methods passage reports glucose changes after a 30-minute pump disconnection, not the time from an occlusion to an alarm. Searches for the 0.5 and 1.0 U/hour comparison and for occlusion-alarm timing found no passage addressing the claim in our copy; the indexed passages have no page labels. (LLM, conf=0.76)
Experimental — accuracy not yet measuredOcclusions of insulin infusion sets occur frequently.
“Occlusions do occur frequently”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [11]
The introduction describes patients voluntarily disconnecting infusion sets, and the Research Design and Methods section studies the glucose effects of a planned 30-minute disconnection (pp. 238–239). Neither addresses whether infusion-set occlusions occur frequently; searches for occlusion, blockage, and their frequency found no relevant passage. (LLM, conf=0.76)
Experimental — accuracy not yet measuredOcclusions of insulin infusion sets often occur without an alarmed warning, or the warning is provided too late.
“often without an alarmed warning or this provided too late”
From Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block (2017) · cites this paper as [11]
The Introduction and Conclusions discuss deliberate infusion-set disconnections and their effects on glucose, not occlusions. Searches for occlusion alarms and delayed warnings found no passage addressing whether occlusions occur without an alarm or whether alarms arrive too late. Page numbers were not supplied for these passages. (LLM, conf=0.76)
Experimental — accuracy not yet measuredBlood glucose values rise 1 mg/dL for each minute an IIS is disconnected from the pump (for at least 30 min) under basal infusion conditions, and the elevation persists 3-3.5 h after reconnecting.
“It has been previously reported that blood glucose values rise 1 mg/dL for each minute an IIS is disconnected from the pump (for at least 30 min), under basal infusion conditions. The elevation of blood glucose concentration persisted for 3–3.5 h after reconnecting the infusion set.19”
From Reduced Silent Occlusions with a Novel Catheter Infusion Set (BD FlowSmart): Results from Two Open-Label Comparative Studies (2016) · cites this paper as [19]
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Cited by
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Insulin Infusion Set Use: European Perspectives and Recommendations
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Insulin Pump Occlusions: For Patients Who Have Been Around the (Infusion) Block
Klonoff, D. C., Freckmann, G., & Heinemann, L. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817700545 · Cited by 41 · see citing works
Gibney, M., Xue, Z., Swinney, M., Bialonczyk, D., & Hirsch, L. (2016) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2015.0342 · Cited by 32 · see citing works
Carlson, A. L., Huyett, L. M., Jantz, J., Chang, A., Vienneau, T., & Ly, T. T. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108735 · Cited by 20 · see citing works
Development of a Real-time Force-based Algorithm for Infusion Failure Detection
Blanco, L. E., Wilcox, J. H., Hughes, M. S., & Lal, R. A. (2024) · Journal of Diabetes Science and Technology · doi:10.1177/19322968241247530 · Cited by 2 · see citing works
- Authors
- Zisser, H.
- Affiliations
- Sansum Diabetes Research Institute (US)
- Corresponding author
- Zisser, Howard
- ORCID
- Zisser, Howard
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2008-02-01
- Volume
- 31
- Issue
- 2
- Pages
- 238-239
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1976713377
- Cited by
- 44
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Insulet Corporation
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Physical Sciences › Engineering › Biomedical Engineering › Intravenous Infusion Technology and Safety
- Keywords
- insulin pump therapy, glycemic excursions, type 1 diabetes, continuous glucose monitoring, glycemic control
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 1, Drug Administration Schedule, Drug Therapy, Female, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Insulin Aspart
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