Most insulin pump users generally change their infusion set and reservoir or cartridge every three days to reduce the risk of hyperglycemia (reduced insulin absorption), and to avoid skin infections and the crystallization of insulin in the reservoir and tubing (blocked catheter).
This frequency is about to change with the arrival of Medtronic’s new extended infusion set, which was recently approved by Health Canada, and which can be worn for up to seven days without any undesirable effects. This innovation is compatible with Medtronic MiniMedTM 630G, 670G, 770G and 780G insulin pumps.
According to a Medtronic press release, the advanced materials used in this infusion set help to reduce insulin preservative loss and maintain insulin stability. The insertion device and its adhesive layer extend wear time up to seven days, in addition to the 300-unit reservoir that enables mid-wear refills without impacting insulin stability.
The extended infusion set is available with the usual tubing lengths (23″ or 32″) and cannula lengths (6 mm or 9 mm).
Comfort and reliability
Two studies were conducted with 250 adults with type 1 diabetes (T1D) who used a MiniMed pump (new infusion set versus a standard set). One of them revealed that a majority of participants were extremely satisfied with the new device’s ease of insertion (79% compared to 34% for the short-duration standard device). Satisfaction levels were similar in terms of comfort (adhesive layer), duration and ease of use, as well as time required to change the infusion set.
Studies have also shown that longer wear times have no negative impact on blood sugar management. Further studies are underway to see whether longer catheter usage times can affect the risk of lipodystrophy.
Good for the soul, the wallet and the environment
Having to change infusion sets every three days requires good management and coordination, and this represents a significant mental load for people with T1D and their families. The new extended infusion set enables users to spend half as much time changing their sets and reservoirs.
This innovation also helps to alleviate another concern raised by people with T1D, i.e., the amount of waste produced by their treatment. Studies have shown that the new set reduces the amount of plastic waste generated by each user by 4.19 lbs (1.9 kg) per year. It’s a step in the right direction for the environment.
There’s also a lesser pinch on the wallet, since there are fewer infusion sets required. Insulin losses are also reduced, because each time users change their perfusion set, they throw away any unused insulin. However, you need to factor in that the monthly price of the extended infusion set is approximately 5% higher than the regular MiniMed Mio Advance infusion sets.
In summary, this new product should help to reduce the burden of T1D management for users of Medtronic insulin pumps. Let’s now hope that other insulin pump companies will follow suit and offer similar options to their users in the near future.
Medtronic. 2022. Santé Canada homologue le premier et seul dispositif de perfusion au monde qui double la durée de port jusqu’à 7 jours pour les pompes à insuline. [Press release]. https://canadanews.fr.medtronic.com/Premier-dispositif-de-perfusion-qui-double-la-duree-de-port-jusqua-7-jours-pour-les-pompes-a-insuline-de-Medtronic.
Bonato L., et al. (2018). Duration of catheter use in patients with diabetes using continuous subcutaneous insulin infusion: a review. Diabetes Technol. and Ther., 20(7), 506-515. https://www.liebertpub.com/doi/10.1089/dia.2018.0110
Ardilouze J-L., et al. (2016). CSII: Longer Catheter Usage Time, a Reasonable Goal. Journal of Diabetes Science and Technology, 10(4):989-990. doi:10.1177/1932296815622647
Brazg, E. et al. (2022). Evaluation of extended infusion set performance in adults with type 1 diabetes: infusion set survival rate and glycemic outcomes from a pivotal trial. Diabetes Technol Ther., 24(2), 533-543. https://www.liebertpub.com/doi/10.1089/dia.2021.0540
Zhang, G. et al. (2022). Development of the extended infusion set and its mechanism of action. Journal of Diabetes Science and Technology, 0(0). https://journals.sagepub.com/doi/10.1177/19322968221112120
Kwa, T. et al. (2021). The improved survival rate and cost-effectiveness of a 7-day continuous subcutaneous insulin infusion set. Journal of Medical Economics, 24(1), 837-845. https://www.tandfonline.com/doi/full/10.1080/13696998.2021.1945784
Written by: Nathalie Kinnard, scientific writter and research assistant
Reviewed by :
- Sarah Haag, RN. BSc.
- Rémi Rabasa-Lhoret, M.D., Ph.D.
- Claude Laforest, Marie-Christine Payette, patient partners for the BETTER project
Linguistic revision by: Marie-Christine Payette