1048-P: Insulin Pump Catheters Can Be Worn Much More Than the Recommended Three Days Free

Background and Objectives: Current recommendation is to change insulin pump catheters every 3 days. The rational supporting this recommendation is weak, mostly historical or anecdotical, and based on habits. Our objective was to determine catheter length of wearing under day-to-day condition.

Methods: Participants with type 1 diabetes (T1D) worn their usual catheter during 2 periods as long as glycemic control was acceptable and insertion site remained comfortable. Data are presented as means ± standard deviations. Hypoglycemia (≤ 3.5 mmol/L) and hyperglycemia (≥ 13.8 mmol/L) were recorded via self-monitoring of blood glucose or continuous glucose monitoring. Each experimental period was separated by a 1-week washout, consisting of the usual catheter management.

Results: Participants (n=22, 12 males, age: 47.1±16.2 years, BMI: 26.6±4.1 kg/m², duration of T1D: 27.5±14.3 years, pump therapy: 8.8±6.2 years, 14 using Medtronic, 8 using Animas, usual catheter wearing: 3.5±0.5 days, insulin: 51.7±15.5 units/day, A1c: 7.4±0.8%) completed 41/44 periods (348.7 experimental days; one subject quitted, 2 catheters accidentally ripped-out). Catheters were worn 8.18±2.93 days, the shortest and the longest periods were respectively 3.81 and 15.61 days. Reasons for removal were uncontrolled glycemia despite bolusing (73%), discomfort (15%), or both (12%). Number of hypoglycemia and hyperglycemia per day were 0.18±0.17 and 0.90±0.56, respectively. No severe hypoglycemia, nor hyperglycemia ≥ 20 mmol/L or ketosis were observed over the study.

Conclusions: Catheters might be worn beyond 3 days, up to 8 days and possibly more, significantly reducing patients and financial burden. Longer-term data are required to ensure that longer catheter wearing is not associated with impact on glucose control or lipohypertrophy.