Frequency and Detection of Insulin Infusion Site Failure in the Type 1 Diabetes Exchange Online Community

Michael S. Hughes, Julia L. Douvas, Madison Layfield-Bryan, Luis E. Blanco, John Clark Gray, Grzegorz Zapotoczny, Juan Espinoza, John H. Wilcox, Rayhan A. Lal*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Insulin infusion site (IIS) failures are a weakness in insulin pump therapy. We examined experience with IIS failures among U.S. individuals with diabetes on insulin pump through survey distributed to the T1D Exchange Online Community. Demographic factors, IIS characteristics, and diabetes-related perceptions were assessed by logistic regression to determine odds of higher (≥1 per month) or lower (<1 per month) reported IIS failure frequency. IIS failures were common; 41.4% reported ≥1 per month. IIS failure is usually detected through development of hyperglycemia rather than pump alarm. No assessed demographic factor or IIS characteristic was predictive; however, higher odds of ≥1 failure per month were associated with feelings of burnout (odds ratios [OR] 1.489 [1.024, 2.165]) and considering pump discontinuation (OR 2.233 [1.455, 3.427]). IIS failures are frequent and unpredictable, typically require hyperglycemia for detection, and are associated with negative perceptions. More should be done toward preventing IIS failures and/or detecting them sooner.

Original languageEnglish (US)
Pages (from-to)426-430
Number of pages5
JournalDiabetes Technology and Therapeutics
Issue number6
StatePublished - Jun 1 2023


  • Failure
  • Insulin infusion set
  • Insulin infusion site
  • Insulin pump
  • Pump malfunction

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Medical Laboratory Technology


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