Frequency and Detection of Insulin Infusion Site Failure in the Type 1 Diabetes Exchange Online Community

Insulin infusion site (IIS) failures are a weakness in insulin pump therapy. We examined experience with IIS failures among U.S. individuals with diabetes on insulin pump through survey distributed to the T1D Exchange Online Community. Demographic factors, IIS characteristics, and diabetes-related perceptions were assessed by logistic regression to determine odds of higher (>= 1 per month) or lower (<1 per month) reported IIS failure frequency. IIS failures were common; 41.4% reported >= 1 per month. IIS failure is usually detected through development of hyperglycemia rather than pump alarm. No assessed demographic factor or IIS characteristic was predictive; however, higher odds of >= 1 failure per month were associated with feelings of burnout (odds ratios [OR] 1.489 [1.024, 2.165]) and considering pump discontinuation (OR 2.233 [1.455, 3.427]). IIS failures are frequent and unpredictable, typically require hyperglycemia for detection, and are associated with negative perceptions. More should be done toward preventing IIS failures and/or detecting them sooner.

Automated summary

Insulin infusion site (IIS) failures are common in individuals with diabetes on insulin pump therapy and often go undetected until hyperglycemia occurs. These failures are associated with negative perceptions and may be prevented or detected sooner through additional measures.