{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T23:17:28Z","timestamp":1794007048112,"version":"4.8.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Insulin pump therapy can be adversely affected by interruption of insulin flow, leading to a rise in blood glucose (BG) and subsequently of blood beta-hydroxybutyrate (BHB) ketone levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a PubMed search for English language reports (January 1982 to July 2024) estimating the rate of rise in BG and\/or BHB after \u2265 60 minutes of interruption of continuous subcutaneous insulin infusion (CSII) in persons with type 1 diabetes (PwT1D). We also simulated the rise in BG in a virtual population of 100 adults with T1D following suspension of continuous subcutaneous insulin infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified eight relevant studies where BG and BHB (seven of these eight studies) were measured following suspension of CSII as a model for occlusion. After 60 minutes post-suspension, the mean extracted rates of rise averaged 0.62 mg\/dL\/min (37 mg\/dL\/h) for BG and 0.0038 mmol\/L\/min (0.20 mmol\/L\/h) for BHB. Mean estimated time to moderately\/severely elevated BG (300\/400 mg\/dL) or BHB (1.6\/3.0 mmol\/L) was, respectively, 5.8\/8.5 and 8.0\/14.2 hours. The simulation model predicted moderately\/severely elevated BG (300\/400 mg\/dL) after 9.25\/12, 6.75\/8.75, and 4.75\/5.75 hours in the virtual subjects post-interruption with small (5th percentile), medium (50th percentile), and large (95th percentile) hyperglycemic changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Clinical studies and a simulation model similarly predicted that, following CSII interruption, moderate\/severe hyperglycemia can occur within 5-9\/6-14 hours, and clinical studies predicted that moderate\/severe ketonemia can occur within 7-12\/13-21 hours. Patients and clinicians should be aware of this timing when considering the risks of developing metabolic complications after insulin pump occlusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19322968241280386","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T01:07:57Z","timestamp":1725671277000},"page":"1472-1479","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6394-6862","authenticated-orcid":false,"given":"David C.","family":"Klonoff","sequence":"first","affiliation":[{"name":"Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3054-3207","authenticated-orcid":false,"given":"Alessandra T.","family":"Ayers","sequence":"additional","affiliation":[{"name":"Diabetes Technology Society, Burlingame, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3067-1004","authenticated-orcid":false,"given":"Cindy N.","family":"Ho","sequence":"additional","affiliation":[{"name":"Diabetes Technology Society, Burlingame, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7575-4622","authenticated-orcid":false,"given":"Chiara","family":"Fabris","sequence":"additional","affiliation":[{"name":"Center for Diabetes Technology, The University of Virginia, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0839-4070","authenticated-orcid":false,"given":"Mar\u00eda Fernanda","family":"Villa-Tamayo","sequence":"additional","affiliation":[{"name":"Center for Diabetes Technology, The University of Virginia, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2573-4882","authenticated-orcid":false,"given":"Eleanor","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7992-9506","authenticated-orcid":false,"given":"Eda","family":"Cengiz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3263-1419","authenticated-orcid":false,"given":"Laya","family":"Ekhlaspour","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0573-6650","authenticated-orcid":false,"given":"Jenise C.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2493-1304","authenticated-orcid":false,"given":"Lutz","family":"Heineman","sequence":"additional","affiliation":[{"name":"Science Consulting in Diabetes GmbH, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5459-5044","authenticated-orcid":false,"given":"Michael A.","family":"Kohn","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0005"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.46747\/cfp.6812893"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.69.10.809"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1553-7250(09)35029-1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-018-1151-3"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.24926\/iip.v12i1.3577"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci24-0032"},{"key":"e_1_3_3_9_2","unstructured":"Diabetes (type 1 and type 2) in children and young people: diagnosis and management. 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