The evidence for recommendations to change insulin infusion sets (IIS) at least every 2-3 days is limited. In this study, an extended indwelling time of IIS and its impact on glycemic control were investigated.
Forty subjects were advised to wear IIS for up to 7 days in daily life. Each subject used two YpsoPump® Orbit®soft (soft cannula) and two YpsoPump® Orbit®micro (steel needle) IIS. Early replacements were documented and glucose levels were monitored (Dexcom G5TM Mobile). For IIS surviving 7 days, subjects’ glycemic control was compared between days.
Of 160 tested IIS, 66% were used for 7 days. Mean wearing time was 6.2±1.5 days with no considerable difference between steel and soft cannula IIS. Main early replacements reasons were suspected occlusions (n=30) and adhesive failure (n=7). Mean glucose concentration (n=105 IIS) was 146±21 mg/dl during the first 3 days and 148±18 mg/dl during the whole 7 days and coefficient of variation was 34±7% vs. 33±5%. Daily insulin demand was 40±11 U (day 1-3) vs. 41±11 U (day 1-7). Infusion site reactions were mild and resolved within a few days without treatment. No infusion site infection occurred.
Prolonged indwelling of IIS did not have a clinically relevant impact on glycemic control. IIS tolerability was good and appeared comparable to 3-day use. An individual wearing time of up to 7 days is possible if no obvious reason for earlier change such as occlusion, adhesive failure or inflammation occurs.