title: Improving Patient Experience With Insulin Infusion Sets: Practical Guidelines and Future Directions.
abstract: Insulin infusion sets (IISs) are an essential component of safe and effective insulin pump therapy. Establishing best practices for their use has been impeded by a lack of formal study and limited resources for clinician and patient education. Recent innovations in IIS science promise to change this status quo by increasing awareness of such problems as unexplained hyperglycemia and infusion set occlusion.
  
  
  
  In August 2015, a panel of diabetologists and certified diabetes educators from various disciplines was convened to reconsider IIS-related complications of pump therapy, to better characterize infusion set factors affecting patient experience, and to update priorities for optimizing current technologies. Actionable guidelines were provided for addressing common issues, including skin reactions, site rotation and set changes, dislodgment of the infusion set, and partial or complete blockage of the catheter. These issues may underlie episodes of IIS failure and/or unexplained hyperglycemia.
  
  
  
  Development of practical tools and standardized guidelines for empowering patients to prevent, diagnose, and troubleshoot IIS problems that contribute to unexplained hyperglycemia will be necessary to realize the full benefit of insulin pump therapy along the continuum of diabetes education.
authors.affiliation: Diabetes Care Center, University of Washington School of Medicine, Seattle, Washington (Ms Evert, Dr Hirsch)
authors.forename: Alison B
authors.initials: AB
authors.lastname: Evert
authors.affiliation: Atlanta Diabetes Associates / Emory University, Atlanta, Georgia (Dr Bode)
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Bode
authors.affiliation: Stanford School of Medicine, Palo Alto, California (Dr Buckingham)
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Buckingham
authors.affiliation: St Peter's Health Partners Medical Associates, Albany, New York (Ms Nardacci)
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Nardacci
authors.affiliation: Diabetes Education Group, Lakeville, Connecticut (Ms Verderese)
authors.forename: Carol A
authors.initials: CA
authors.lastname: Verderese
authors.affiliation: Florida Health Care Plan, Palm Coast, Florida (Dr Wolff-McDonagh)
authors.forename: Phyllis
authors.initials: P
authors.lastname: Wolff-McDonagh
authors.affiliation: Advanced Metabolic Care and Research, San Diego, California (Mr Walsh)
authors.forename: John
authors.initials: J
authors.lastname: Walsh
authors.affiliation: Diabetes Care Center, University of Washington School of Medicine, Seattle, Washington (Ms Evert, Dr Hirsch)
authors.forename: Irl B
authors.initials: IB
authors.lastname: Hirsch
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D057785:Catheters; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000517:prevention & control; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D010353:Patient Education as Topic / Q000592:standards*; D000076251:Wearable Electronic Devices
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin