Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion
An erratum to this article was published (J Diabetes Sci Technol, May 2025 ↗)
Authors' conclusion
Clinical studies and a simulation model similarly predicted that, following CSII interruption, moderate/severe hyperglycemia can occur within 5-9/6-14 hours, and clinical studies predicted that moderate/severe ketonemia can occur within 7-12/13-21 hours. Patients and clinicians should be aware of this timing when considering the risks of developing metabolic complications after insulin pump occlusion.
Study context
- Population
- Persons with T1D after ≥60 minutes of continuous subcutaneous insulin infusion (CSII) interruption (suspension as a model for occlusion)8 studies
- Comparison
- Clinical studies vs Simulation model
- Simulation modeln = 100
- Outcome
- Rate of rise in BG and/or BHB and time to moderately/severely elevated BG or BHB after CSII interruption
Methodological detailsPubMed search (January 1982 to July 2024), simulation in virtual population
- PubMed search (January 1982 to July 2024)
- Simulation in virtual population
Main finding
As reported in the abstract
Rates of rise and time to moderate/severe hyperglycemia and ketonemia after CSII suspension · after 60 minutes post-suspension
- Mean rate of rise of blood glucose (BG) (clinical studies)
- 0.62 mg/dL/min (37 mg/dL/h)
- Mean rate of rise of beta-hydroxybutyrate (BHB) (clinical studies)
- 0.0038 mmol/L/min (0.20 mmol/L/h)
- Mean estimated time to moderately/severely elevated BG (300/400 mg/dL) (clinical studies)
- 5.8/8.5 hours
- Mean estimated time to moderately/severely elevated BHB (1.6/3.0 mmol/L) (clinical studies)
- 8.0/14.2 hours
- Simulation: time to moderately/severely elevated BG (300/400 mg/dL), small (5th percentile) hyperglycemic changes
- 9.25/12 hours
- Simulation: time to moderately/severely elevated BG (300/400 mg/dL), medium (50th percentile) hyperglycemic changes
- 6.75/8.75 hours
- Simulation: time to moderately/severely elevated BG (300/400 mg/dL), large (95th percentile) hyperglycemic changes
- 4.75/5.75 hours
Original publication
Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion. J Diabetes Sci Technol. Published 6 September 2024. doi:10.
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