Combined improvements in implantable pump technology and insulin stability allow safe and effective long term intraperitoneal insulin delivery in type 1 diabetic patients: the EVADIAC experience

Gin, H.; Renard, Éric; Melki, V.; Boivin, S; Schaepelynck-Bélicar, P.; Guerci, Bruno; Jl, Selam; Brun, J. M.; Riveline, JP; Estour, Bruno; Catargi, Bogdan

doi:10.1016/s1262-3636(07)70075-7

Cited by 61 publications

(41 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have demonstrated the feasibility of using implantable programmable insulin pumps and the intraperitoneal (IP) route for insulin delivery [90][91][92][93][94][95]. The main advantage of this route is that it restores the physiological insulin gradient between the portal vein and the peripheral circulation.…”

Section: Ias and Continuous Intraperitoneal Insulin Infusionmentioning

confidence: 99%

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Radermecker

Renard

Scheen

2009

Diabetes Metabolism Res

View full text Add to dashboard Cite

The purification of animal insulin preparations and the use of human recombinant insulin have markedly reduced the incidence, but not completely suppressed, the development of anti-insulin antibodies (IAs). Advances in technologies concerning the mode of delivery of insulin, i.e. continuous subcutaneous insulin infusion (CSII), continuous peritoneal insulin infusion (CPII) and more recently inhaled insulin administration, appear to significantly increase circulating levels of immunoglobulin G (IgG) anti-IAs in diabetic patients. However, the increase is usually moderate and mostly transient as compared to previous observations with poorly purified animal insulin preparations. The clinical impact of these circulating anti-IAs remains unclear. Nevertheless, several studies have suggested that antibodies could retard insulin action, leading to a worsening of postprandial hyperglycaemia and/or serve as a carrier, thus leading to unexpected hypoglycaemia. CPII may be associated with more marked and sustained increase in IAs levels, possibly related to the use of an unstable insulin and the formation of immunogenic aggregates of insulin. The possible clinical consequences of these high levels of IAs remain to be evaluated because a low-glucose morning syndrome or severe insulin resistance with ketone bodies production have been reported in some cases. In conclusion, even if CSII and CPII may promote the development of circulating IAs, this increase does not lead to immunological insulin resistance, compared to that previously described with animal non-purified insulin preparations, and seems to have only marginal influence on blood glucose control or complications in most diabetic patients.

show abstract

Section: Ias and Continuous Intraperitoneal Insulin Infusionmentioning

confidence: 99%

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Radermecker

Renard

Scheen

2009

Diabetes Metabolism Res

View full text Add to dashboard Cite

show abstract

“…Three times a pump was explanted because of pump-site infections during a total of 153 patient-years (1 in 51 patientyears) [9]. Others reported incidences of pump-site infection of 1 per 53 and 56 patient-years and of re-intervention because of catheter problems or electronic failure of 1 per 22 patient-years, respectively [11,12].…”

Section: Introductionmentioning

confidence: 99%

Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump

Haveman

Logtenberg

Kleefstra

et al. 2008

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…70 CIPII as part of a closed-loop system would potentially imply an improvement on both issues, due to the almost physiological insulin absorption route, which allows a faster blood glucose normalization after a meal [9][10][11][12] and the positive results obtained with CIPII for hypoglycemia control. 16,19,22,24,25,43 A small study on the use of intraperitoneal insulin delivery as part of a closed-loop system also showed the potential for this combination. A marked and sustained elevation of anti-insulin antibodies (IAs), possibly due to the use of unstable insulin and consequently, the formation of immunogenic aggregates of insulin has been reported with CIPII.…”

Section: Potential For Closed-loop Insulin Delivery Systems (Artificimentioning

confidence: 99%

A New Optimized Percutaneous Access System for CIPII

Garcia-Verdugo¹,

Erbach²,

Schnell

2017

J Diabetes Sci Technol

View full text Add to dashboard Cite

In recent years, continuous intraperitoneal insulin infusion (CIPII) has become a favored treatment alternative for patients with subcutaneous insulin resistance, mainly due to its ability of mimicking physiological conditions of insulin absorption. CIPII has been shown to improve glycemic control as well as to reduce hypoglycemic events and to lead to increased patient satisfaction and quality of life (QoL). Among CIPII delivery systems, Diaport stands out due to its low side effects, its demonstrated clinical efficacy and the potential for integration into closed-loop systems.

show abstract

Combined improvements in implantable pump technology and insulin stability allow safe and effective long term intraperitoneal insulin delivery in type 1 diabetic patients: the EVADIAC experience

Cited by 61 publications

References 14 publications

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control

Surgical aspects and complications of continuous intraperitoneal insulin infusion with an implantable pump

A New Optimized Percutaneous Access System for CIPII

Contact Info

Product

Resources

About