position of insulin can make differance of delivery rate

November 27, 2008

Position of Insulin Pump Can Cause Fluctuations In Insulin Delivery Rates

A new study showed that changes in the position of a conventional insulin

pump, relative to its infusion set, can significantly impact expected

insulin

delivery rates. The rates depending on how the insulin pump was worn varied

from 74.5% of the expected delivery upward to 123.3% of expected delivery

rates.

Such changes may occur during routine daily activities such as getting

dressed, sleeping or showering. This siphon effect has been reported

previously in

hospital IV pumps, but this is the first time it has been investigated in

continuous subcutaneous insulin infusion pumps.

" Insulin pump therapy allows for precise control of insulin delivery for

patients with type 1 diabetes. However, in this study, we saw that a

conventional

pump's insulin delivery rate can fluctuate significantly due to changes in

the pump's height relative to its infusion set and the end of the tubing.

This

can increase blood glucose variability, which previous research has shown to

be a risk factor for the progression of complications of diabetes, " said

lead

investigator Zisser, MD, Director of Clinical Research and Diabetes

Technology at the Sansum Diabetes Research Institute in Santa Barbara, CA.

The investigators reached this finding by quantifying the effect of

hydrostatic pressure (the pressure exerted on a portion of a column of fluid

as a result

of the weight of the fluid above it) on insulin delivery during bolus

dosages, basal rates and static changes in insulin pumps. They tested

conventional

insulin pumps from Medtronic Diabetes (MiniMed 512 & 515, which uses 110 cm

tubing) and s Medical (Deltec Cozmo 1700, which uses 80 cm tubing), and

also compared them to the tubing-free pump from Insulet Corporation

(OmniPod).

They found that raising or lowering a conventional insulin pump, to the full

extent of its tubing, can significantly affect the accuracy of insulin

delivery,

especially at low basal infusion rates. " This is particularly important for

children, for whom low basal rates are often used, " Dr. Zisser noted. The

most

pronounced differences were seen during basal delivery in the Cozmo and

MiniMed pumps. For the 1U/hr rate, differences ranged from 74.5% of the

expected

delivery when the pumps were below the pipettes and pumping upward to 123.3%

when the pumps were above the pipettes and pumping downward. For the 1.5U/hr

rate, differences ranged from 86.7% to 117.0% when the pumps were below or

above the pipettes, respectively.

In contrast, the OmniPod, which has no external tubing, was the least

affected by pumping orientation and direction. For the 1U/hr rate, its

differences

only ranged from 98.3% when its delivery cannula was in a level pumping

position to 101.3% when the cannula was in an upward pumping position. For

the

1.5U/hr rate, its differences only ranged from 96.0% in a level pumping

position to 102.5% in an upward pumping position.

The researchers measured the change in the fluid level in an in-line

graduated glass pipette when the Cozmo and MiniMed pumps were moved either

up or down

to its maximum length in relation to the end of the tubing/pipette. For the

OmniPod, the unit was held in a clamp vertically with the delivery cannula

up for " upward " pumping position and the delivery cannula down for the

" downward " pumping position. The OmniPod was horizontal for the level

pumping position.

The study was supported by a grant from Insulet Corporation (Nasdaq: PODD)

of Bedford, MA.

Presented at the Annual Meeting of the Diabetes Technology Society, Nov.

2008

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Issue 444

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This article originally posted

November 25, 2008

and appeared in

Issue 444

Position of Insulin Pump Can Cause Fluctuations In Insulin Delivery Rates

A new study showed that changes in the position of a conventional insulin

pump, relative to its infusion set, can significantly impact expected

insulin

delivery rates. The rates depending on how the insulin pump was worn varied

from 74.5% of the expected delivery upward to 123.3% of expected delivery

rates.

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This article originally posted

November 25, 2008

and appeared in

Issue 444

Position of Insulin Pump Can Cause Fluctuations In Insulin Delivery Rates

A new study showed that changes in the position of a conventional insulin

pump, relative to its infusion set, can significantly impact expected

insulin

delivery rates. The rates depending on how the insulin pump was worn varied

from 74.5% of the expected delivery upward to 123.3% of expected delivery

rates.

Diabetes In Control Sponsors

http://www.diabetesincontrol.com/aserver/adclick.php?n=a8e6d6c1

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addtomyyahooPosition of Insulin Pump Can Cause Fluctuations In Insulin

Delivery Rates

A new study showed that changes in the position of a conventional insulin

pump, relative to its infusion set, can significantly impact expected

insulin

delivery rates. The rates depending on how the insulin pump was worn varied

from 74.5% of the expected delivery upward to 123.3% of expected delivery

rates.

Such changes may occur during routine daily activities such as getting

dressed, sleeping or showering. This siphon effect has been reported

previously in

hospital IV pumps, but this is the first time it has been investigated in

continuous subcutaneous insulin infusion pumps.

" Insulin pump therapy allows for precise control of insulin delivery for

patients with type 1 diabetes. However, in this study, we saw that a

conventional

pump's insulin delivery rate can fluctuate significantly due to changes in

the pump's height relative to its infusion set and the end of the tubing.

This

can increase blood glucose variability, which previous research has shown to

be a risk factor for the progression of complications of diabetes, " said

lead

investigator Zisser, MD, Director of Clinical Research and Diabetes

Technology at the Sansum Diabetes Research Institute in Santa Barbara, CA.

The investigators reached this finding by quantifying the effect of

hydrostatic pressure (the pressure exerted on a portion of a column of fluid

as a result

of the weight of the fluid above it) on insulin delivery during bolus

dosages, basal rates and static changes in insulin pumps. They tested

conventional

insulin pumps from Medtronic Diabetes (MiniMed 512 & 515, which uses 110 cm

tubing) and s Medical (Deltec Cozmo 1700, which uses 80 cm tubing), and

also compared them to the tubing-free pump from Insulet Corporation

(OmniPod).

They found that raising or lowering a conventional insulin pump, to the full

extent of its tubing, can significantly affect the accuracy of insulin

delivery,

especially at low basal infusion rates. " This is particularly important for

children, for whom low basal rates are often used, " Dr. Zisser noted. The

most

pronounced differences were seen during basal delivery in the Cozmo and

MiniMed pumps. For the 1U/hr rate, differences ranged from 74.5% of the

expected

delivery when the pumps were below the pipettes and pumping upward to 123.3%

when the pumps were above the pipettes and pumping downward. For the 1.5U/hr

rate, differences ranged from 86.7% to 117.0% when the pumps were below or

above the pipettes, respectively.

In contrast, the OmniPod, which has no external tubing, was the least

affected by pumping orientation and direction. For the 1U/hr rate, its

differences

only ranged from 98.3% when its delivery cannula was in a level pumping

position to 101.3% when the cannula was in an upward pumping position. For

the

1.5U/hr rate, its differences only ranged from 96.0% in a level pumping

position to 102.5% in an upward pumping position.

The researchers measured the change in the fluid level in an in-line

graduated glass pipette when the Cozmo and MiniMed pumps were moved either

up or down

to its maximum length in relation to the end of the tubing/pipette. For the

OmniPod, the unit was held in a clamp vertically with the delivery cannula

up for " upward " pumping position and the delivery cannula down for the

" downward " pumping position. The OmniPod was horizontal for the level

pumping position.

The study was supported by a grant from Insulet Corporation (Nasdaq: PODD)

of Bedford, MA.

Presented at the Annual Meeting of the Diabetes Technology Society, Nov.

2008

Send to Friend

| Share |

Print |

Category |

Home

This article originally posted November 25, 2008 and appeared in

Issue 444

Past five issues:

Issue 444 |

Issue 443 |

Issue 442 |

Issue 441 |

Have a comment?

Post it here.

Visit the NEW Diabetes In Control Blog.

Click Here!

There are no comments to this article at this time.

Be the first!

Archive

About Us

Contact Us

Advertising

Current Studies

Previous Studies

Request Insight Svcs

Newsflash

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Continuing Education

Test Your Knowledge

Tools for your Practice

link region type: RECT

Send to Friend

| Share |

Print |

Category |

Home

This article originally posted

November 25, 2008

and appeared in

Issue 444

Position of Insulin Pump Can Cause Fluctuations In Insulin Delivery Rates

A new study showed that changes in the position of a conventional insulin

pump, relative to its infusion set, can significantly impact expected

insulin

delivery rates. The rates depending on how the insulin pump was worn varied

from 74.5% of the expected delivery upward to 123.3% of expected delivery

rates.

Diabetes In Control Sponsors

http://www.diabetesincontrol.com/aserver/adclick.php?n=a8e6d6c1

Flash movie end

Print This Week's Newsletter

Download This Week's Newsletter

Newsletter is in Adobe format

If you don't have Adobe Acrobat Reader, you can download it for Free

here.

Free CE Available

CE Programs On Diabetes Available

here

alltop

Flash movie start

http://www.diabetesincontrol.com/aserver/adclick.php?bannerid=67 & zoneid=1 & so

urce= & dest=http%3A%2F%2Fwww.disetronic-usa.com%2Fdstrnc_us%2Frewrite%2Fgener

alContent%2Fen_US%2Fweb_form%2FDCM_web_form_01.htm

Sign up for our FREE Weekly Newsletter

Current Issue

Past Issue

Diabetes In Control. News and Information for Medical Professionals

News and Information for Medical Professionals

Search Diabetes In Control

http://www.diabetesincontrol.com/newsite_sept2008/DinCart/production%20art/b

utnsearch.gif

Current Spotlight Newsletter

Spotlight Product Reviews

New Products

Archive

About Us

Contact Us

Advertising

Current Studies

Previous Studies

Request Insight Svcs

Newsflash

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Features

Feature Writers

Past Newsletters

Continuing Education

Test Your Knowledge

Tools for your Practice

link region type: RECT

Send to Friend

| Share |

Print |

Category |

Home

This article originally posted

November 25, 2008

and appeared in

Issue 444

Position of Insulin Pump Can Cause Fluctuations In Insulin Delivery Rates

A new study showed that changes in the position of a conventional insulin

pump, relative to its infusion set, can significantly impact expected

insulin

delivery rates. The rates depending on how the insulin pump was worn varied

from 74.5% of the expected delivery upward to 123.3% of expected delivery

rates.

Diabetes In Control Sponsors

http://www.diabetesincontrol.com/aserver/adclick.php?n=a8e6d6c1

Flash movie end

Sign up for our FREE Weekly Newsletter

Current Issue

Past Issue

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