[Diabetes-talk] Fw: position of insulin can make differance of delivery rate
Mike Freeman
k7uij at panix.com
Thu Nov 27 18:53:25 UTC 2008
Caveat: the study below was funded (not surprisingly) by the makers of
the OmniPod. Nevertheless, the findings make sense.
Mike Freeman
----- Original Message -----
From: "Patricia LaFrance-Wolf" <plawolf at earthlink.net>
To: "Blind-Diabetics at Yahoogroups. Com"
<blind-diabetics at yahoogroups.com>; "Acb-Diabetics at Acb. Org"
<acb-diabetics at acb.org>
Sent: Thursday, November 27, 2008 10:24 AM
Subject: [acb-diabetics] position of insulin can make differance of
delivery rate
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 Howard 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 Smiths 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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This article originally posted November 25, 2008 and appeared in
Issue 444
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Issue 444 |
Issue 443 |
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Issue 442 |
Issue 441 |
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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 Howard 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 Smiths 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 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!
Top Ten Most Read Articles:
A Spoonful of Vinegar Helps the Sugar Go Down
Read: 40056 Times
5 Sample Meal Plans, from 1200 to 2200 calories, in English and Spanish
Read: 18835 Times
Diabetes 101
Read: 16058 Times
New Type 3 Diabetes Discovered
Read: 14845 Times
Oral Insulin Spray (Oral-lyn) for Type 1 and 2 Diabetes in Ecuador
Read: 14434 Times
It's not just another glargine LevemirR
Read: 11878 Times
The GlucoBand-New Non-Invasive Continuous Blood Glucose Monitor-
Read: 11653 Times
Chili Extract A Possible Cure for Diabetes
Read: 11159 Times
Weight Training and Diabetes
Read: 9599 Times
Drugs in Development
Read: 9395 Times
See more most read...
Browse by Feature Writer & Article Category
A. Lee Dellon, MD |
Beverly Price |
Birgitta I. Rice, MS |
Did You Know |
Dr. Bernstein |
Dr. Brian Jakes, Jr. |
Dr. Frank Varon, DDS |
Dr. Fred Pescatore |
Dr. Walter Willett |
Education |
Eric S. Freedland |
Evan D. Rosen |
Facts |
Features |
Ginger Kanzer-Lewis |
Items for the Week |
James Anderson, MD |
Joseph M. Caporusso |
Kristina Sandstedt |
Laura Plunkett |
Leonard Lipson, M.A. |
Lester A. Packer |
Melissa Diane Smith |
New Products |
Newsflash |
Paul Chous, M.A., OD |
Philip A. Wood PhD |
R. Keith Campbell |
Sheri R. Colberg PhD |
Sherri Shafer |
Steve Pohlit |
Studies |
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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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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
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