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Implantation of programmable infusion pumps for insulin delivery in type I diabetic patients

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Summary

Five type I diabetic patients were followed prospectively during treatment with continuous subcutaneous insulin infusion by externally worn pumps and during the first 12 months after implantation of a remote-controlled insulin infusion device (ID1, Siemens AG). Stabilized insulin (Hoe 21 GH, Hoechst AG) was infused intravenously in two and intraperitoneally in three patients. Total observation time was 47.2 patient-months after implantation. Two devices had to be explanted prematurely, one because of a technical failure after 101 days, one due to a skin necrosis over the implant after 236 days. HbA1, frequency of hypoglycemia, total insulin dose, and basal rate infusion did not change after implantation. There was a reduction in the insulin antibodies 6 months after start of intravenous or intraperitoneal insulin delivery. Fasting plasma free insulin levels could be normalized only by intraperitoneal insulin infusion. Although a technical and a surgical problem was observed, our data show the successful implantation and clinical use of programmable dosing devices and stabilized insulin.

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Abbreviations

CSII:

continuous subcutaneous insulin infusion

CIVII:

continuous intravenous insulin infusion

CIPII:

continuous intraperitoneal insulin infusion

ICT:

intensified conventional therapy

BMI:

body mass index

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Walter, H., Günther, A., Kronski, D. et al. Implantation of programmable infusion pumps for insulin delivery in type I diabetic patients. Klin Wochenschr 67, 583–587 (1989). https://doi.org/10.1007/BF01721685

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Key words

  • Insulin infusion pump
  • Implantation
  • CSII
  • Intravenous, intraperitoneal insulin infusion