Clinical review: insulin pump-associated adverse events in adults and children

Abstract

This timely review covers all potential insulin pump-associated adverse events, including their incidence, features, impacts, and contributory factors such as the pump user. The importance of ongoing anticipatory education and support for patients and families using this intensive insulin technology is highlighted, which if done well should improve the overall experience of pump therapy for users, and hopefully reduce the incidence and impact of severe adverse events.

A novel nanoemulsion-based method to produce ultrasmall, water-dispersible nanoparticles from chitosan, surface modified with cell-penetrating peptide for oral delivery of proteins and peptides

“…2,3 Oral delivery of insulin has some crucial advantages, including high patient compliance, ease of administration and more patient adherence to the therapy, and, more importantly, it is the sole route of administration that potentially mimics the physiological insulin secretion seen in nondiabetic individuals, 4 thus relieving the patients from hyperinsulinemia and its consequent complications such as nephropathy and neuropathy. 5 However, oral delivery of insulin has two main bottlenecks, the harsh and degrading enzymatic situation of the gastrointestinal tract that inactivates insulin very quickly and the mucosal barrier that limits insulin's oral bioavailability. 6,7 Numerous approaches have been applied to bypass the enzyme barrier, and some of them have achieved promising results.…”

Weight‐based carbohydrate treatment of hypoglycaemia in people with Type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial

“…The use of CSII is increasingly common in the modern management of children and adults with Type 1 diabetes, allowing them to manage their diabetes intensively and optimize glycaemic control . While CSII offers advantages over traditional insulin delivery systems by providing greater flexibility in the timing of meals and snacks, it still does not protect the patient from hypoglycaemia.…”

Biopsychosocial Factors Associated With Satisfaction and Sustained Use of Artificial Pancreas Technology and Its Components: a Call to the Technology Field

“…Fine-tuning alert settings can enhance CGM utility, but may not reduce the social burden of having attention called to the CGM user’s T1D. Many studies have documented the technical difficulties that individuals with T1D experience using insulin pumps including software problems, key pad failure/problem, battery issues, cracked/physical damage, insulin leaks, and set/site failures including occlusion [76, 81–84]. Although overall discontinuation rates for insulin pump use were low in both the T1D Exchange Registry data (3%) and the DPV database (4%), reasons for discontinuation included problems with wearability (57%), disliking the pump and/or feeling anxious about it (44%), and problems with glycemic control (30%).…”