The improved survival rate and cost-effectiveness of a 7-day continuous subcutaneous insulin infusion set

Kwa, Timothy; Zhang, Gina; Shepard, Katie M.; Wherry, Kael; Chattaraj, Sarnath

doi:10.1080/13696998.2021.1945784

Cited by 5 publications

(8 citation statements)

References 54 publications

(55 reference statements)

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“…The amount of insulin lost depends on the patient's TDD and can range from 289 to 512 units per year for a 2-to 3-day set, or 72.8 to 258 units per year for a 7-day set. 28 Differences in device lifetimes between the standard IIS and EWISs also contribute to differential insulin wastage. A standard set without failures will last 72 hours before it must be removed and replaced.…”

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

“…There are three areas where insulin is lost during a reservoir change or IIS change. The first is reservoir change waste, which involves unusable insulin (which is about 41.3 units) 28 that remains in the reservoir after it is replaced. This means that each time a reservoir is exchanged on its scheduled change date, 41.3 units of insulin are lost.…”

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

“…The range of infusion set change waste is 17.4 to 25.1 units each time an IIS is replaced. 28 The third is residual reservoir waste, which involves the insulin remaining in the reservoir when the IIS fails within one day of a scheduled set change. In other words, although the insulin in the reservoir is not completely used, the reservoir must be removed early with less than one day of insulin remaining.…”

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

“…The amount of insulin lost depends on the patient’s TDD and can range from 289 to 512 units per year for a 2- to 3-day set, or 72.8 to 258 units per year for a 7-day set. 28…”

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

“…Taking the market cost of insulin to be $338.44/1000 units, the calculated annual savings range from $881 to $1677 depending on the TDD. 28 This estimate does not factor into account any additional cost savings from minimizing adverse events or by reducing plastic wastage. Future studies have been developed to assess the actual cost-effectiveness of saved insulin and the number of quality-adjusted life years gained by using the MEIS.…”

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

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Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Nguyen

Buckingham

et al. 2022

J Diabetes Sci Technol

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Continuous subcutaneous insulin infusion (CSII) therapy is becoming increasingly popular. CSII provides convenient insulin delivery, precise dosing, easy adjustments for physical activity, stress, or illness, and integration with continuous glucose monitors in hybrid or other closed-loop systems. However, even as insulin pump hardware and software have advanced, technology for insulin infusion sets (IISs) has stayed relatively stagnant over time and is often referred to as the “Achilles heel” of CSII. To discuss barriers to insulin pump therapy and present information about advancements in, and results from clinical trials of extended wear IISs, Diabetes Technology Society virtually hosted the “Improving the Patient Experience with Longer Wear Infusion Sets Symposium” on December 1, 2021. The symposium featured experts in the field of IISs, including representatives from Steno Diabetes Center Copenhagen, University of California San Francisco, Stanford University, Medtronic Diabetes, and Science Consulting in Diabetes. The webinar’s seven speakers covered (1) advancements in insulin pump therapy, (2) efficacy of longer wear infusion sets, and (3) innovations to reduce plastics and insulin waste.

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Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

“…The amount of insulin lost depends on the patient’s TDD and can range from 289 to 512 units per year for a 2- to 3-day set, or 72.8 to 258 units per year for a 7-day set. 28…”

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

Section: Cost Savings Of Reduced Insulin Waste With Longer Wear Setsmentioning

confidence: 99%

See 3 more Smart Citations

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Nguyen

Buckingham

et al. 2022

J Diabetes Sci Technol

Self Cite

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Fluid Mechanism Analysis of Insulin Pump Set Failure Based on Power Bond Graph

Wang,

Guo,

Pei

et al. 2024

Mechanisms and Machine Science

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Inflammation at Site of Insulin Infusion Diminishes Glycemic Control

Kesserwan¹,

Lewis²,

Li³

et al. 2022

Journal of Pharmaceutical Sciences

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The approximation of euglycemia is the most effective means of preventing diabetic complications, which is achieved through effective insulin delivery. Recent reports indicate that insulin phenolic preservatives, which are found in all commercial insulin formulations, are cytotoxic, pro-inflammatory and induce secondary fibrosis. Therefore, we hypothesize that these preservatives induce an inflammatory response at the site of insulin infusion leading to diminished glycemic control and adverse pharmacokinetic outcomes. Insulin degradation by inflammatory cell proteases was quantitated following protease treatment in vitro. A modified murine air pouch model was utilized to evaluate the relative inflammatory responses following infusions of saline, insulin preservatives, and insulin, utilizing the adjuvant irritant thioglycolate. Blood glucose levels were monitored in diabetic mice with and without air pouch irritation. A pharmacokinetic analysis evaluated insulin effectiveness for diabetic mice between these two conditions. Inflammatory cells are significantly present in insulin preservative-induced inflammation, which effects diminished blood glucose control by both insulin uptake and degradation. Insulin containing these preservatives resulted in similar degrees of inflammation as observed with the irritant thioglycolate. These studies imply that the preservative agents found in commercial insulin formulations induce an intense localized inflammatory reaction. This inflammatory reaction may be responsible for the premature failure of insulin infusion devices. Future studies directed at reducing this inflammatory reaction may prove to be an important step in extending the lifespan of insulin infusion devices.

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The improved survival rate and cost-effectiveness of a 7-day continuous subcutaneous insulin infusion set

Cited by 5 publications

References 54 publications

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Fluid Mechanism Analysis of Insulin Pump Set Failure Based on Power Bond Graph

Inflammation at Site of Insulin Infusion Diminishes Glycemic Control

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