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September 17, 2008

Blood Tests and Insulin Injections, Daily Care

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Question from North Olmsted, Ohio, USA:

Do people have trouble using the I-Port injection port made by Patton Medical Services? We were encouraged to try it by our endocrinologist. Our nine-year-old son, diagnosed with type 1 at age four, was very excited to try it in order to cut down on the number of injections. The Nurse Practitioner watched as I placed it and said I did it accurately, but we have not been able to get it to function properly. His numbers after receiving insulin are way too high and it’s clear he’s not getting the insulin. I’ve talked to the nurse and she advised calling the manufacturer, which I have not yet done. When I asked her if anyone else seems to have this issue, she said, in truth, that they only have one other family that has continued to use it and she was not sure why others discontinued their usage (whether it be cost or ineffectiveness)

Answer:

From: DTeam Staff

The I-Port is a neat little device. It sort of combines the features of an insulin-pump infusion system and the easy of giving injections, but there are potential pitfalls. One that seems to be common, in my view, is that sometimes people overlook that the catheter device can retain a few units of insulin. So, for patients who only take a few units of insulin via the I-Port, the dose may get “hung up” in the I-Port catheter and never really get delivered. There are a couple of proposed ways to get around this, including giving “extra” insulin by a few units (you can judge this with a non-inserted I-Port) with the dose. You can also “flush” the I-Port after a dose with a little bit of sterile saline solution.

Other potential I-Port pitfalls are similar to those of insulin pump catheter problems. For example, if the I-Port catheter “kinks,” then the insulin will not flow out properly. You can tell if this happened when you pull out the I-Port. Also, it is not clear how well the I-Port works when you mix insulin doses such as giving a dose of Lantus or other long-acting insulin through the I-Port and follow it with a dose of fast-acting. For example, it has been recommended for a long time to not mix Lantus with other insulins in the same injection.

DS

[Editor’s comment: If you are having problems with kinking, you might want to consider trying an insuflon, an angled indwelling catheter. Furthermore, see a previous question about mixing insulins in an indwelling catheter.

BH]