Long-Term Therapy of IDDM With an Implantable Insulin Pump

Abstract

Long-term implantable pump therapy maintained HbA1c in a range similar to intensive subcutaneous therapy, but with fewer episodes of severe hypoglycemia. Although pump and catheter occlusions remain a limitation, patient satisfaction with implantable pump therapy remains high.

Quality of Life and Technology: Impact on Children and Families With Diabetes

“…The intraperitoneal insulin infusion pump has shown improvements in QOL compared to standard insulin pump treatment[105, 106], although the comparative impact on HbA1c remains unclear[106, 107]. Inhaled insulin has also shown improvements in glycemic control and treatment satisfaction in a randomized controlled trial with adult type 1 diabetes patients[108, 109].…”

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

“…Its safety and efficacy has been reported by the Evaluation of Active Implants in Diabetes (EVADIAC) study group and others [1][2][3][4][5][6]. Better glycaemic control in terms of lower HbA 1c , decreased number of hypoglycaemic events and reduced glycaemic variability can be achieved and patients' treatment satisfaction is high [1][2][3][4][5][6][7][8].…”

Catheter Survival During Long-Term Insulin Therapy With an Implanted Programmable Pump

“…The description of the Infusaid Model 1000 pump (Strato/Infusaid, Norwood, MA) and the results of the clinical trial in patients with type I diabetes are reported elsewhere (2,5). The device is implanted in a subcutaneous pocket created within the abdominal wall and attached to the fascia.…”

“…D uring insulin therapy using an implanted pump, catheter complications are observed with both intraperitoneal and intravenous delivery (1)(2)(3)(4)(5)(6)(7). Occlusions, caused by deposition of insulin aggregates inside the lumen and by fibrous tissue growth or clotting at the tip and inside the distal end, are the most frequent catheter complications (8)(9)(10)(11).…”

“…In implantable devices with sideports (i.e., a direct access to the insulin path between the outlet valve of the pumping unit and the catheter hub) (2,5,6), catheter patency can be documented by measuring catheter resistance by a minimally invasive procedure (12). Furthermore, flushing the catheter with buffer solution through the sideport can be attempted to clear occlusions (12).…”