ESPE Abstracts

Background: Multiple daily injections of insulin for children and young people with diabetes can be very daunting and, some have a phobia of needles. As a result, for some individuals, the use of an i-port device can be life-changing and help with their diabetes management. The i-port is an injection port that enables diabetes patients to administer their insulin without having to puncture their skin multiple times in a day. In most cases, the i-port can stay in place for up to 3 days, before it needs to be replaced. We report three type 1 diabetes cases, in which their i-ports failed to deliver insulin and therefore, resulted in all three cases presenting to hospital with DKA (Diabetic Ketoacidosis).

Description: 14-year old girl, who 24 hours prior to her admission, had high blood sugar readings. She and her parents gave insulin correction doses, which did not have an effect on her blood sugar readings. 10-year old girl, whose parents were unable to get her blood glucose and ketone levels in range. It was noted that her i-port cannula was kinked and leaking. 8-year old boy, whose father gave multiple correction doses for high blood sugar readings. However, his blood sugar readings remained high. His father then stopped using the i-port and gave a further dose of insulin subcutaneously. However, by this time he was in DKA. All three cases presented in DKA due to failure to deliver insulin through their i-port devices. They all required admission to high dependency unit for treatment with intravenous insulin and fluids. All were discharged within 48 hours, with safety netting advice and had one week follow up with the paediatric diabetes nurse, for further education around how to promptly and effectively manage their i-port devices. In addition, they also had follow up in the multidisciplinary paediatric diabetes outpatient clinic.

Discussion: These cases highlight the message that failure of i-port devices can be life-threatening, especially if it is not dealt with promptly. Regular education around the appropriate management and use of i-port devices to patients and their families is paramount.