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Accuracy of Bolus and Basal Rate Delivery of Different Insulin Pump Systems.

ABSTRACT: BACKGROUND:Insulin pumps are used for basal rate and bolus insulin delivery in patients with diabetes. In this in vitro study, accuracy of delivery of different commercial insulin pumps was evaluated. MATERIALS AND METHODS:Accuracy of 10 different insulin pump systems (5 durable pumps with different insulin infusion sets and 1 patch pump) was tested with a microgravimetric method. Mean bolus accuracy of 25 successive 1?U boluses and of 12 successive 10?U boluses was assessed, and delivery time for 10?U boluses was measured. Basal rate accuracy at 1.0?U/h was evaluated for 72?h and for individual 1-h windows. RESULTS:Mean bolus delivery was within ±5% of target for both tested bolus sizes, but precision of individual boluses was higher with the larger boluses. Delivery times varied between the different pump models but agreed with the specifications of the respective manufacturers. Regarding basal rate accuracy, the total deviation for 72?h was very small in all pumps; however, larger deviations were observed during the first 12?h. For the patch pump, large variations between individual 1-h windows were observed. CONCLUSIONS:In general, all compared insulin pump systems showed a similar level of accuracy. Differences, especially between durable pumps and the patch pump, were observed when considering each hour of basal rate delivery separately.

SUBMITTER: Freckmann G

PROVIDER: S-EPMC6477586 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Accuracy of Bolus and Basal Rate Delivery of Different Insulin Pump Systems.

Freckmann Guido G Kamecke Ulrike U Waldenmaier Delia D Haug Cornelia C Ziegler Ralph R

Diabetes technology & therapeutics 20190322 4

<h4>Background</h4>Insulin pumps are used for basal rate and bolus insulin delivery in patients with diabetes. In this in vitro study, accuracy of delivery of different commercial insulin pumps was evaluated.<h4>Materials and methods</h4>Accuracy of 10 different insulin pump systems (5 durable pumps with different insulin infusion sets and 1 patch pump) was tested with a microgravimetric method. Mean bolus accuracy of 25 successive 1 U boluses and of 12 successive 10 U boluses was assessed, and ...[more]

PMID: 30901232

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Project description:IntroductionTo date, there have been few head-to-head comparisons between semaglutide once-weekly (OW) and short-acting meal-time insulin in participants with type 2 diabetes (T2D) treated with basal insulin and requiring treatment intensification. This indirect comparison evaluated the effects of these regimens on glycated haemoglobin (HbA1c), body weight, hypoglycaemia, and other clinically relevant outcomes.MethodsA post-hoc, unanchored, individual participant data meta-analysis was conducted on the basis of data from single treatment arms in the SUSTAIN 5 and DUAL 7 trials. Semaglutide 0.5 mg OW and 1.0 mg OW plus basal insulin were compared with an optimised (treat-to-target) basal-bolus regimen of insulin glargine and insulin aspart over 26 weeks, using regression adjustment to account for baseline differences between the trials.ResultsOver 26 weeks, semaglutide 1.0 mg OW plus basal insulin reduced mean HbA1c by significantly more than the basal-bolus regimen (treatment difference: - 0.36%; p = 0.003), while semaglutide 0.5 mg OW plus basal insulin was comparable with basal-bolus insulin (treatment difference: 0.08%, p = 0.53). Both doses of semaglutide were associated with significant weight loss relative to insulin intensification (treatment differences: 6.8-9.4 kg; p < 0.001). At both doses, semaglutide intensification required less basal insulin per day than bolus intensification, and more participants on semaglutide met HbA1c targets of < 7.0% and ≤ 6.5% without hypoglycaemia or weight gain (odds ratio [OR] for < 7.0%, 21.9; OR for ≤ 6.5%, 16.2; both p < 0.001).ConclusionsIn T2D uncontrolled by basal insulin, intensification with semaglutide 1.0 mg OW was associated with better glycaemic control, weight loss, and reduced hypoglycaemia versus a basal-bolus regimen, while limiting the treatment burden associated with frequent injections. Clinicians could consider treatment intensification with semaglutide when T2D is uncontrolled by basal insulin, especially when weight management is a priority. Effective glycaemic control coupled with weight management can alleviate the burden of diabetes-associated complications.

Dataset Information

Accuracy of Bolus and Basal Rate Delivery of Different Insulin Pump Systems.

Publications

Accuracy of Bolus and Basal Rate Delivery of Different Insulin Pump Systems.

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