Related Experiment Video
Updated: Aug 28, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
DKA Prevention and Insulin Pumps: Lessons Learned From a Large Pediatric Pump Practice
Elizabeth Ann Doyle1, Stuart Alan Weinzimer2, William Tamborlane2
1Yale University School of Nursing, Orange, Connecticut.
Diabetic ketoacidosis (DKA) is uncommon in youth using insulin pumps, but often preventable. Education on pump troubleshooting is crucial, especially for teens with high A1C levels, even those using continuous glucose monitors (CGMs).
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Technology
Background:
- Diabetic ketoacidosis (DKA) remains a significant complication in youth with type 1 diabetes (T1D).
- Insulin pump therapy and continuous glucose monitors (CGMs) are increasingly used to manage T1D in pediatric populations.
- Understanding DKA incidence and contributing factors in this cohort is essential for effective prevention strategies.
Purpose of the Study:
- To report recent incidence data for DKA in young insulin pump users with T1D.
- To evaluate the impact of CGMs on DKA rates among these patients.
- To identify common causes of DKA events in this population.
Main Methods:
- Retrospective chart review of insulin pump users (under 26 years) from December 2019 to June 2021.
- Analysis of 591 patients, with a focus on DKA event occurrence, severity, and patient characteristics.
- Comparison of DKA severity between CGM users and non-users.
Main Results:
- DKA incidence was 3.16 events per 100 patient-years among 591 pump users.
- Most DKA events occurred in adolescents (85.7% aged 12-19) with high A1C (mean 10.2%) and longer diabetes duration.
- Pump site failure (57.1%) was the most common cause; CGM use did not significantly alter DKA severity.
Conclusions:
- DKA events are relatively infrequent in youth using insulin pumps but are often preventable.
- Reinforced DKA prevention education is vital, particularly for adolescents with elevated A1C levels.
- Even CGM users require frequent educational reinforcement regarding DKA prevention and pump troubleshooting.
More Related Videos
Related Concept Videos
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Insulin Formulations: Types and Delivery
Short-acting insulins are divided into...
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes Mellitus: Type 2 and Gestational
Insulin: Biosynthesis, Chemistry, and Preparation
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment...

