Identifying the Achilles’ Heel of Insulin Pump Technology

“It really doesn’t matter how good the technology is,” he said. “We still don’t understand what is happening with the infusion sites, much less fix it.”

This study, performed between 2020 and 2022 (paused due to the pandemic) enrolled 30 participants from the UW Medicine Diabetes Institute. It was the first such step to answer both these questions.

The study participants were divided into two groups: those patients using insulin pumps for 10 years or less, and those using pumps for over 20 years. Researchers expected to see more pathology – thickening of skin, damage to the subdermal layer, inflammation – in the group using the pumps for 20 years or more. That’s not what happened.

“We found that the pathology, to our surprise, was no different when short-term user results were compared with long-term users,” he said.

Both groups had high levels of eosinophils, disease-fighting white blood cells that usually appears in the blood to fight allergies. Generally, they assist in healing the skin and creating fibrosis.

“This is the last thing you want at an infusing site,” Hirsch said.

“From a bigger point of view of fibrosis, inflammation and eosinophils, we saw all this in both groups, but we don’t understand yet why it’s happening,” he said. “How much was the catheter or the insulin causing the irritation around the sites? How much was it from the preservatives or is this because of the insulin pump itself?”

In addition, some patients move the injection site from place to place because of irritation, and other patients have no irritation at all. Yet, researchers don’t know why.

All these questions need to be answered in future studies, he said.

“Ninety-three percent of those in the study complained of itching, which points to eosinophils being present, but we are also going to look at metabolomics,” he said. “The real goal of all of this is to minimize skin damage and improve the experience for our patients.

Source: Eurekalert