Obstruction of infusion sets is a major cause of metabolic deterioration or even ketoacidosis during continuous subcutaneous insulin infusion (CSII). 21 type I, CSII-treated patients were studied in a prospective, randomized cross over design during two periods of three months to assess the effects of Genapol stabilized human insulin (HOE 21 PH H-TRONIN) on obstruction frequency of PVC catheters in comparison with a neutral preparation of biosynthetic human insulin (BHI). In a total observation time of 9.5 patient-years 79 catheter obstructions by precipitated insulin occurred with an incidence of 0.67 episodes per patient-month for BHI and 0.026 for HOE 21 PH. Improvement of metabolic control paralleled the reduction of obstruction frequency by HOE 21 PH. Thus, a stabilized insulin preparation is recommended for use in CSII to reduce the therapeutic risk.
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