Insulin infusion sets associated with adverse events: strategies for improved diabetes education
IntroductionInsulin Infusion Sets (IIS) play a crucial role in ensuring the safe delivery of insulin through a Continuous Subcutaneous Insulin Infusion (CSII) for individuals with Type 1 Diabetes (T1D). Recent advancements in therapy have highlighted the need to address issues such as unexplained hy...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1275394/full |
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| author | Ana Lucia Domingues Neves Luiz Eduardo Galvão Martins Mônica Andrade Lima Gabbay Mônica Andrade Lima Gabbay Paula Pascali Tiago de Oliveira Aldo Martinazzo Sérgio Atala Dib Sérgio Atala Dib Dulce Elena Casarini Sebastião Vagner Aredes Fernanda Silva Tenorio Tatiana Sousa Cunha |
| author_facet | Ana Lucia Domingues Neves Luiz Eduardo Galvão Martins Mônica Andrade Lima Gabbay Mônica Andrade Lima Gabbay Paula Pascali Tiago de Oliveira Aldo Martinazzo Sérgio Atala Dib Sérgio Atala Dib Dulce Elena Casarini Sebastião Vagner Aredes Fernanda Silva Tenorio Tatiana Sousa Cunha |
| author_sort | Ana Lucia Domingues Neves |
| collection | DOAJ |
| description | IntroductionInsulin Infusion Sets (IIS) play a crucial role in ensuring the safe delivery of insulin through a Continuous Subcutaneous Insulin Infusion (CSII) for individuals with Type 1 Diabetes (T1D). Recent advancements in therapy have highlighted the need to address issues such as unexplained hyperglycemia and IIS occlusion.ObjectiveTo investigate the adverse events (AEs) associated with IIS that impact the treatment of T1D, with a specific focus on promoting effective educational practices.MethodsOne hundred and eighteen patients under treatment at the Diabetes Center Insulin Pump Ambulatory, Federal University of São Paulo responded to a semi-structured questionnaire. Over 6 months, a nurse researcher interviewed them via video calls.ResultsCatheter-related adverse events (AEs) included catheter knots, folding, and accidental traction. AEs associated with cannula use were mainly related to cannula fixation adhesive, insulin leakage, bleeding episodes, and skin problems. The cannula patch tends to detach easily in hot conditions or when used for more than 3 days, leading to local itching. Adhesive glue can cause redness and pain. Insulin leakage typically occurs after the catheter disconnects from the cannula, accidental cannula traction, or beneath the cannula patch. Bleeding has been reported inside the cannula or at the insertion site, resulting in local pain and, in some cases, obstruction of insulin flow. When accidental cannula traction occurs, it is recommended to replace the entire IIS system. In situations involving bleeding, leakage, insulin odor, or unsuccessful attempts to correct hyperglycemic episodes with a “bolus” of insulin, it is advisable to change the IIS system and evaluate appropriate techniques for handling and infusing the device. Moreover, regular inspections of the device and reservoir/cartridge are essential.ConclusionSerious AEs can occur even in cases where the occlusion alarm is not activated, leading to interruptions in insulin flow. Conversely, in less severe situations, alarm activation can occur even in the absence of insulin flow interruption. Accidental catheter traction and catheter bending are commonly encountered in everyday situations, while issues related to the cannula directly affect blood glucose levels. AEs related to the IIS cannula often involve insulin leakage into the skin, bleeding, and skin events attributed to adhesive issues with the cannula. |
| first_indexed | 2024-03-09T14:11:22Z |
| format | Article |
| id | doaj.art-ec2756ef838b4b65a2ca9bf35a5d0cac |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-09T14:11:22Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-ec2756ef838b4b65a2ca9bf35a5d0cac2023-11-29T11:11:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-11-011010.3389/fmed.2023.12753941275394Insulin infusion sets associated with adverse events: strategies for improved diabetes educationAna Lucia Domingues Neves0Luiz Eduardo Galvão Martins1Mônica Andrade Lima Gabbay2Mônica Andrade Lima Gabbay3Paula Pascali4Tiago de Oliveira5Aldo Martinazzo6Sérgio Atala Dib7Sérgio Atala Dib8Dulce Elena Casarini9Sebastião Vagner Aredes10Fernanda Silva Tenorio11Tatiana Sousa Cunha12Postgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilDepartment of Science and Technology, Institute of Science and Technology, Federal University of São Paulo, São Paulo, BrazilDepartment of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilDiabetes Center Insulin Pump Ambulatory, Federal University of São Paulo, São Paulo, BrazilDiabetes Center Insulin Pump Ambulatory, Federal University of São Paulo, São Paulo, BrazilDepartment of Science and Technology, Institute of Science and Technology, Federal University of São Paulo, São Paulo, BrazilPostgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilDepartment of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilDiabetes Center Insulin Pump Ambulatory, Federal University of São Paulo, São Paulo, BrazilPostgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilDeltaLife, São José dos Campos, BrazilPostgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, BrazilDepartment of Science and Technology, Institute of Science and Technology, Federal University of São Paulo, São Paulo, BrazilIntroductionInsulin Infusion Sets (IIS) play a crucial role in ensuring the safe delivery of insulin through a Continuous Subcutaneous Insulin Infusion (CSII) for individuals with Type 1 Diabetes (T1D). Recent advancements in therapy have highlighted the need to address issues such as unexplained hyperglycemia and IIS occlusion.ObjectiveTo investigate the adverse events (AEs) associated with IIS that impact the treatment of T1D, with a specific focus on promoting effective educational practices.MethodsOne hundred and eighteen patients under treatment at the Diabetes Center Insulin Pump Ambulatory, Federal University of São Paulo responded to a semi-structured questionnaire. Over 6 months, a nurse researcher interviewed them via video calls.ResultsCatheter-related adverse events (AEs) included catheter knots, folding, and accidental traction. AEs associated with cannula use were mainly related to cannula fixation adhesive, insulin leakage, bleeding episodes, and skin problems. The cannula patch tends to detach easily in hot conditions or when used for more than 3 days, leading to local itching. Adhesive glue can cause redness and pain. Insulin leakage typically occurs after the catheter disconnects from the cannula, accidental cannula traction, or beneath the cannula patch. Bleeding has been reported inside the cannula or at the insertion site, resulting in local pain and, in some cases, obstruction of insulin flow. When accidental cannula traction occurs, it is recommended to replace the entire IIS system. In situations involving bleeding, leakage, insulin odor, or unsuccessful attempts to correct hyperglycemic episodes with a “bolus” of insulin, it is advisable to change the IIS system and evaluate appropriate techniques for handling and infusing the device. Moreover, regular inspections of the device and reservoir/cartridge are essential.ConclusionSerious AEs can occur even in cases where the occlusion alarm is not activated, leading to interruptions in insulin flow. Conversely, in less severe situations, alarm activation can occur even in the absence of insulin flow interruption. Accidental catheter traction and catheter bending are commonly encountered in everyday situations, while issues related to the cannula directly affect blood glucose levels. AEs related to the IIS cannula often involve insulin leakage into the skin, bleeding, and skin events attributed to adhesive issues with the cannula.https://www.frontiersin.org/articles/10.3389/fmed.2023.1275394/fullinsulin infusion systemtechnologydiabetes mellitus, type 1catheterscannula |
| spellingShingle | Ana Lucia Domingues Neves Luiz Eduardo Galvão Martins Mônica Andrade Lima Gabbay Mônica Andrade Lima Gabbay Paula Pascali Tiago de Oliveira Aldo Martinazzo Sérgio Atala Dib Sérgio Atala Dib Dulce Elena Casarini Sebastião Vagner Aredes Fernanda Silva Tenorio Tatiana Sousa Cunha Insulin infusion sets associated with adverse events: strategies for improved diabetes education Frontiers in Medicine insulin infusion system technology diabetes mellitus, type 1 catheters cannula |
| title | Insulin infusion sets associated with adverse events: strategies for improved diabetes education |
| title_full | Insulin infusion sets associated with adverse events: strategies for improved diabetes education |
| title_fullStr | Insulin infusion sets associated with adverse events: strategies for improved diabetes education |
| title_full_unstemmed | Insulin infusion sets associated with adverse events: strategies for improved diabetes education |
| title_short | Insulin infusion sets associated with adverse events: strategies for improved diabetes education |
| title_sort | insulin infusion sets associated with adverse events strategies for improved diabetes education |
| topic | insulin infusion system technology diabetes mellitus, type 1 catheters cannula |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1275394/full |
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