Impact of Targeted Education on Managing Warning and Error Signals by Children and Adolescents with Type 1 Diabetes Using the Accu-Chek Combo Insulin Pump System

Overview

Journal Ann Pediatr Endocrinol Metab

Specialty Pediatrics

Date 2017 Oct 13

PMID 29025203

Citations 2

Authors

Asma Deeb

Nabras Al Qahtani

Amal Al Ali

Mariette Akle

Affiliations

Soon will be listed here.

Abstract

Purpose: Insulin pumps are widely used in diabetes. They are equipped with safety alarms to alert users. Pump manuals contain alarm codes and how to troubleshoot them. However, these manuals are lengthy and difficult to use, particularly in emergencies. We aim to assess the impact of targeted education on warnings and errors in improving competency to troubleshoot the alarms.

Methods: Twenty-one patients, with a median age of 13, were recruited over a 5-month period. Each patient had 2 study visits. The frequencies and types of alarms were recorded, and patients were given a summary sheet that outlined common alarms encountered and troubleshooting tips. In visit 2, the frequencies and types of alarms were compared to those of visit 1. The patients were asked to fill a questionnaire and to rate the education session given in visit 1, their level of competency in decrypting alarm codes, and their promptness in responding to alarms.

Results: Low cartridge (W1), low battery (W2), and bolus cancelled (W8) were the commonest warnings. The most noted errors were occlusion (E4), power interruption (E8), empty battery (E2), set not primed (E11), and cartridge empty (E1). The numbers of warning and error signals markedly decreased after targeted education (P<0.05). The ability in decrypting warning signals significantly improved (P=0.02), and the frequency of response to pump alarms significantly increased (P=0.001).

Conclusions: Certain warnings and errors are more common than others in insulin pumps. Targeted education is useful in improving competency and response of patients in managing pump alarms.

Citing Articles

Insulin infusion sets associated with adverse events: strategies for improved diabetes education.

Neves A, Martins L, Gabbay M, Pascali P, De Oliveira T, Martinazzo A Front Med (Lausanne). 2023; 10:1275394.

PMID: 38093983 PMC: 10716844. DOI: 10.3389/fmed.2023.1275394.

Insulin Pump-Associated Adverse Events in a Brazilian Reference Center for the Treatment of Diabetes Mellitus: Proposal for a Taxonomy of Device Failures in Adults, Adolescents, and Children.

Neves A, Martins L, Gabbay M, Cavicchioli G, Tenorio F, Cunha T J Diabetes Sci Technol. 2022; 18(1):74-81.

PMID: 35771027 PMC: 10899856. DOI: 10.1177/19322968221106196.

References

Gibney M, Xue Z, Swinney M, Bialonczyk D, Hirsch L . Reduced Silent Occlusions with a Novel Catheter Infusion Set (BD FlowSmart): Results from Two Open-Label Comparative Studies. Diabetes Technol Ther. 2015; 18(3):136-43. PMC: 4790215. DOI: 10.1089/dia.2015.0342. View

OConnell M, Donath S, Cameron F . Poor adherence to integral daily tasks limits the efficacy of CSII in youth. Pediatr Diabetes. 2011; 12(6):556-9. DOI: 10.1111/j.1399-5448.2010.00740.x. View

Kerr D, Morton J, Whately-Smith C, Everett J, Begley J . Laboratory-based non-clinical comparison of occlusion rates using three rapid-acting insulin analogs in continuous subcutaneous insulin infusion catheters using low flow rates. J Diabetes Sci Technol. 2009; 2(3):450-5. PMC: 2769745. DOI: 10.1177/193229680800200314. View

McMahon S, Airey F, Marangou D, McElwee K, Carne C, Clarey A . Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life. Diabet Med. 2004; 22(1):92-6. DOI: 10.1111/j.1464-5491.2004.01359.x. View

Schmid V, Hohberg C, Borchert M, Forst T, Pfutzner A . Pilot study for assessment of optimal frequency for changing catheters in insulin pump therapy-trouble starts on day 3. J Diabetes Sci Technol. 2010; 4(4):976-82. PMC: 2909532. DOI: 10.1177/193229681000400429. View

Deeb A, Abu-Awad S, Abood S, El-Abiary M, Al-Jubeh J, Yousef H . Important determinants of diabetes control in insulin pump therapy in patients with type 1 diabetes mellitus. Diabetes Technol Ther. 2014; 17(3):166-70. DOI: 10.1089/dia.2014.0224. View

Zisser H . Quantifying the impact of a short-interval interruption of insulin-pump infusion sets on glycemic excursions. Diabetes Care. 2007; 31(2):238-9. DOI: 10.2337/dc07-1757. View

Liberman A, Buckingham B, Phillip M . Diabetes technology and the human factor. Int J Clin Pract Suppl. 2011; (170):83-90. DOI: 10.1111/j.1742-1241.2010.02583.x. View

Weissberg-Benchell J, Antisdel-Lomaglio J, Seshadri R . Insulin pump therapy: a meta-analysis. Diabetes Care. 2003; 26(4):1079-87. DOI: 10.2337/diacare.26.4.1079. View

10.

van Bon A, Bode B, Sert-Langeron C, DeVries J, Charpentier G . Insulin glulisine compared to insulin aspart and to insulin lispro administered by continuous subcutaneous insulin infusion in patients with type 1 diabetes: a randomized controlled trial. Diabetes Technol Ther. 2011; 13(6):607-14. DOI: 10.1089/dia.2010.0224. View

11.

Bangstad H, Danne T, Deeb L, Jarosz-Chobot P, Urakami T, Hanas R . ISPAD Clinical Practice Consensus Guidelines 2006-2007. Insulin treatment. Pediatr Diabetes. 2007; 8(2):88-102. DOI: 10.1111/j.1399-5448.2007.00233.x. View

12.

Grunberger G, Abelseth J, Bailey T, Bode B, Handelsman Y, Hellman R . Consensus Statement by the American Association of Clinical Endocrinologists/American College of Endocrinology insulin pump management task force. Endocr Pract. 2014; 20(5):463-89. DOI: 10.4158/EP14145.PS. View

13.

Danne T, von Schutz W, Lange K, Nestoris C, Datz N, Kordonouri O . Current practice of insulin pump therapy in children and adolescents - the Hannover recipe. Pediatr Diabetes. 2006; 7 Suppl 4:25-31. DOI: 10.1111/j.1399-543X.2006.00166.x. View