title: Patch pump versus conventional pump: postprandial glycemic excursions and the influence of wear time.
abstract: OBJECTIVE
  The aim of this study was to compare blood glucose and plasma insulin profiles after bolus insulin infusion by a patch pump (PP) versus a conventional pump (CP), directly after placement and after Day 3 of use.
  
  
  METHODS
  Twenty patients with type 1 diabetes came in for two blocks of visits: one block of two visits while wearing the OmniPod® (Insulet Corp., Bedford, MA) insulin pump (PP) and one block of two visits while wearing the Medtronic Diabetes (Northridge, CA) Paradigm® pump (CP). Patients administered an identical mealtime insulin bolus of at least 6 IU.
  
  
  RESULTS
  For PP, maximum glucose levels were 28.7% lower on Day 3 (P=0.020), when maximum insulin levels were 30.3% higher (P=0.002). For CP, maximum glucose levels were 26.5% lower on Day 3 (P=0.015), when maximum insulin levels were 46.4% higher (P=0.003). Glucose levels (mean [interquartile range]) were significantly lower on Day 3 for PP (168.2 [145.8] mg/dL vs. 139.4 [77.8] mg/dL; P=0.013), but not significantly so for CP (159.0 [66.1] mg/dL vs. 139.5 [57.9] mg/dL; P=0.084). Mean insulin levels were significantly higher on Day 3 for CP (195 [120] pmol/L vs. 230 [90] pmol/L; P=0.01), but not significantly so for PP (178 [106] pmol/L vs. 194 [120] pmol/L; P=0.099). There were no significant differences between the two catheter lengths.
  
  
  CONCLUSIONS
  Postprandial glycemic excursions were lower on Day 3 of catheter wear time, but there were no differences between PPs and CPs. These findings support the proposal that catheter wear time plays an important role in insulin absorption.
authors: Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands. y.m.luijf@gmail.com
authors: Yoeri M
authors: YM
authors: Luijf
authors: Sabine
authors: S
authors: Arnolds
authors: Angelo
authors: A
authors: Avogaro
authors: Carsten
authors: C
authors: Benesch
authors: Daniela
authors: D
authors: Bruttomesso
authors: Anne
authors: A
authors: Farret
authors: Lutz
authors: L
authors: Heinemann
authors: Jerome
authors: J
authors: Place
authors: Eric
authors: E
authors: Renard
authors: Rachele
authors: R
authors: Scotton
authors: J Hans
authors: JH
authors: DeVries
mesh_terms: D000279:Administration, Cutaneous; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000295:instrumentation*; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D055104:Infusions, Subcutaneous; D007332:Insulin Infusion Systems; D061268:Insulin Lispro / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D008422:Materials Testing; D019518:Postprandial Period; D012869:Skin Absorption; D057968:Transdermal Patch
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D061268:Insulin Lispro
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